<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000100038</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Primer trasplante de intestino delgado en Costa Rica]]></article-title>
<article-title xml:lang="en"><![CDATA[First small bowel transplant in Costa Rica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Arias]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Jara]]></surname>
<given-names><![CDATA[Vanessa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araya-Chavarría]]></surname>
<given-names><![CDATA[Sheila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital &#8220;Dr. Rafael Ángel Calderón Guardia&#8221; Programa de Trasplantes de órganos abdominales ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>1</numero>
<fpage>38</fpage>
<lpage>41</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000100038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000100038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000100038&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El primer trasplante de intestino exitoso realizado en humanos se llevó a cabo en 1988, en Alemania, por el Dr. Deltz. Sin embargo, no es hasta diciembre de 2013, cuando en Costa Rica, en el hospital &#8220;Dr. Rafael Ángel Calderón Guardia&#8221;, se efectúa el primer trasplante humano de intestino delgado del país y la región. Se reporta el caso de un masculino de 18 años que tuvo isquemia intestinal masiva, secundaria a herida por arma blanca en abdomen, con compromiso vascular. El injerto provino de donador cadavérico. La inmunosupresión se basó en baxiliximab, tacrolimus, prednisona y micofenolato mofetil. Se reintervino en 7 ocasiones por complicaciones quirúrgicas; desarrolló lesión renal asociada a tacrolimus, mielotoxicidad y trombosis venosa profunda de venas ilíacas. Se mantuvo por 29 días con nutrición parenteral total; se avanzó a vía oral normal a los 40 días del trasplante. Se evaluó el injerto mediante ileoscopias y toma de biopsias. Finalmente, después de 68 días, fallece debido a rechazo agudo severo del injerto.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The first successful small bowel transplant was performed in1988 in Germany by Dr Deltz and co workers. However in Costa Rica it was until december 2013 that was done the first small bowel transplant at the Dr. Rafael Angel Calderon Guardia Hospital. It also became the first small bowel transplant in Central America. This report the case of a young male that had a stabb wound in his abdomen and developed a massive mesenteric ischemia with vascular compromise. The allograft was procured from a cadaveric donor. The recipient received immunosuppression with baxiliximab, tacrolimus, prednisone y micophenolate mofetil. Due to surgical complications the patient underwent 7 more surgeries, he developed tacrolimus induced renal dysfunction, myelotoxicity and iliac deep venous thrombosis. He remained under total parenteral nutrition for 29 days post transplant, then oral intake was introduced and by the day 40 he was a full oral nutrition. Serial endoscopies and biopsies were performed during the weeks after transplantation. Finally at day 68 the patient dies due to acute severe rejection.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[trasplante]]></kwd>
<kwd lng="es"><![CDATA[intestino delgado]]></kwd>
<kwd lng="es"><![CDATA[inmunosupresión]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
<kwd lng="en"><![CDATA[Transplant]]></kwd>
<kwd lng="en"><![CDATA[small bowel]]></kwd>
<kwd lng="en"><![CDATA[immunosuppression]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
</kwd-group>
</article-meta>
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