752:
was highest for liver-intestine (pediatric) patients. Deaths among all pediatric groups awaiting intestine-liver transplants have decreased in the years leading up to 2014 whereas adult intestine-liver deaths have dropped less dramatically. The decrease in recent years is likely due to improved care of infants with intestinal failure and subsequently a decrease in referrals for transplant. Although many improvements have been made in the States, outcomes everywhere still demonstrate much room for improvement. Worldwide, 25% of pediatric patients on the waitlist for an intestinal transplant die before they can receive one.
706:. Therefore, ensuring cardiac survival and nearby donor-recipient proximity before procurement are essential so organs do not wait too long outside the body and without blood flow. Not only is there a lack of transplantable intestines, but a deficiency in the number of centers possessing the capability to carry out the complicated transplant procedure as well. As of 2005, there were only 61 medical centers in the world capable of executing an intestinal transplant. Furthermore, many young, small children, particularly those weighing less than 5
1174:. At one-year, graft survival rates for isolated intestine currently waver around 80%, and 70% for intestine-liver and multivisceral. Over the same time period, patient survival for isolated intestine patients may even exceed 90%, while the more complicated multiorgan transplants do not show any increase in patient survival when compared to patients surviving with the intestinal graft alone. The five-year survival rate for patients and transplants ranges from 50 to 80% (overall mean 60%), depending on underlying disease and presurgical
1157:/mL in the jejunoileum and 10–10 CFU/mL in the colon. While suppression of the immune system may prevent immune attack on the new allograft, it may also prevent the immune system's ability to keep certain gut microbial populations in line. Despite pre and post-decontamination of the transplant, recipients are at risk of local and systemic infection by both natural and external flora. The common symptom of graft dysfunction, whether due to infection, rejection, or some other condition, is
903:
573:. If the intestine is too large, it may be not transplantable into young or small patients. Ideally, intestines should be selected from donors of lighter weight than the proposed recipients to ensure simple closure of the abdominal wound. If a patient is too young or too old, they may not be hardy enough to survive the operation and recovery period. If the donor and recipient organs do not meet compatibility requirements, the threat of
261:, oftentimes a secondary condition of some other form of intestinal disease. Short-bowel syndrome was the cause for 73% of American intestinal transplantations in 2008, followed by functional bowel problems for 15% and other causes representing 12% of cases. Natural SBS is mercifully rare, estimated to be 3 per 100,000 births. Surgical removal is the most common cause, performed as a treatment for various
1190:, the frequency of previous surgery, nutritional status, and the level of liver function have been found to affect patient-graft survival . Patients with a pre-transplant diagnosis of volvulus were found to possess a lower risk of mortality. As of 2008, the longest recorded surviving transplant survived for 18 years. Between 1999 and 2008, 131 retransplant procedures were performed in the United States.
42:
1258:
involved in undergoing intestinal transplantation, including the initial hospitalization for the transplant, can range from $ 150,000 to $ 400,000, and reoccurring hospitalizations are common up through the second year. Two to three years post-transplant, the financial cost of transplantation reaches parity with PN and is more cost-effective thereafter.
306:
350:(LILT) technique. Although both procedures contribute to an approximate 70% increase in length, STEP appears somewhat more favorable in terms of lower mortality and progression to transplant. Nevertheless, a positive reception to either procedure may reduce the level of PN required, if not negate its required use altogether.
676:(EBV) antibodies to prevent infection. Particularly in the immunocompromised system necessitated by the transplant, these viruses can wreak havoc on the body and become extremely dangerous, even fatal. Even with healthy physiological levels, ABO and HLA compatibilities, and no signs of bacterial, viral, and
322:, but this is inadequate for many patients as it depends on the remaining intestine's ability to adapt and increase its absorptive capacity. Although more complicated and expensive to perform, any person may receive PN. Although PN can meet all energy, fluid, and nutrient needs and can be performed at home,
1257:
relative to alternate therapies. Total charges to maintain PN at home can reach upwards of $ 150,000 a year, even though the actual cost of nutrition is typically only $ 18 to $ 22 a day. This excludes the cost for additional home support, equipment, and the care of PN-related complications. The cost
1128:
abilities. Immunosuppression is the primary determinant of outcome in small bowel transplantation; the risk for graft rejection is increased by under-immunosuppression and for local and systemic infection with over-immunosuppression. Ensuring an appropriate dose of immunosuppressant can therefore be
175:
in 1972 triggered a revolution in the field of transplant medicine. Due to this discovery, in 1988, the first successful intestinal transplant was performed in
Germany by E. Deltz, followed shortly by teams in France and Canada. Intestinal transplantation was no longer an experimental procedure, but
751:
of 142 days in 2008. The rate of waitlist additions has shifted from year to year; gains increased until 2006 (with 317 added), but then decreased in 2012 (to 124 added). In 2007, only 9% of patients on the U.S. waitlist died while waiting for a transplant. Waitlist mortality peaked around 2002 and
1088:
It is ideal to commence enteral nutrition as early as possible following transplantation. Therefore, a feeding tube connecting to the stomach or jejunum is quickly placed to facilitate rehabilitation. If gastrointestinal function is restored, a diet can be reestablished and cautiously advanced as
688:
A major challenge facing the intestinal transplant enterprise is meeting the need for transplantable intestines, particularly in the United States where the majority of intestinal transplants take place. There exists a narrow timeslot between procurement and transplantation that any organ remains
1193:
The improvement to quality of life following an intestinal transplantation is significant. Of living patients 6 months after transplant, 70% are considered to have regained full intestinal function, 15% are at partial function, and 15% have had their grafts removed. For those with full function,
1181:
Several factors relating to superior patient and graft prognosis have proven to be statistically significant. Patients who have been admitted for transplant directly from home rather than the hospital, younger patients over one year of age, those receiving their first transplant, those receiving
1152:
Intestinal transplants are highly susceptible to infection even more so than the standard immunocompromised recipient of other organs due to the great composition and variety of the gut flora. A complex assortment of microorganisms inhabits the human digestive tract, with concentrations of up to
1115:
Intestinal transplantation is the least performed type of transplant due to a number of unique obstacles. The most major of these is the profound immunosuppression required due to the ability of the intestine to elicit strong immune responses. Because of exposure to a wide range of gut flora and
877:
in the ileum. The jejunum will be separated from the duodenum while preserving the vasculature of the jejunum, ileum, mesentery, and the pancreas. If healthy, the pancreas can oftentimes be retrieved as an additional isolated procurement. The intestinal allograft, when ready to be extracted, is
313:
Regardless of the underlying condition, the loss of intestinal function does not necessarily necessitate a transplant. Several conditions, such as necrotizing enterocolitis or volvulus, may be adequately resolved by other surgical and nonsurgical treatments, especially if SBS never develops. An
1093:
and enteric contents in the ileostomy. Routine surveillance endoscopy and biopsies via the ileostomy should be performed with decreasing frequency over several months to observe signs of rejection, ideally before clinical symptoms present themselves. Should the patient continue to perform well
693:
with preservation solution. This slows organ activity and increases the time they remain viable for transplant. Although chilling and perfusion may extend intestinal lifespans by several hours, failure is still imminent unless transplanted. This duration between the cooling of the organ during
713:
Despite these challenges, obtaining an intestine for transplant is rather probable in the United States. In 2008, there were 212 people on the U.S. intestinal transplant waitlist, 94% of whom were U.S. citizens. Regardless of transplant type, over half of new registrants are 5 years of age or
256:
may severely compromise intestinal function. Despite the danger these conditions may pose in themselves, they may lead to even further, more serious complications that necessitate replacement of the diseased intestine. The single leading cause for an intestinal transplant is affliction with
647:
determination tests should be performed for both the donor and recipient. ABO-incompatible grafts can sometimes be performed on very young pediatric patients, as their immune systems have not fully developed and for whom waiting list mortality remains high. Additionally, blood
1653:"1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR)"
1198:
is high. The ability to resume regular activities such as the ability to consume food and exert control over digestive function is certainly a welcome return for patients. The low quality of life induced by intestinal failure is oftentimes further supplemented by significant
698:. Due to the sensitivity of the intestine to ischemic injury, many potential donor intestines are lost to the events following brain death and trauma. Furthermore, irreversible intestinal damage is seen after approximately only 5 hours of cold ischemia in the form of
1169:
Intestinal transplant outcomes have improved significantly in recent years. Despite mild incongruities in survival rate percentages between centers in North
America, Europe, Australia, and elsewhere, intestinal transplantations mostly approach survivorship rates of
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absorptive capacity should normalize, followed by the absorptive capacity for fats. Once enteral nutrition is capable of providing all nutritional needs, PN can be discontinued. Nearly all patients with a successful transplant are free of PN within one year.
746:
of the
American general population at the time aside from a below-average Asian cohort. ABO blood types also matched the general population, with 31% A, 14% B, 5% AB, and 50% O. In 2004, the average waiting period to receive a transplant was 220 days, with a
620:; in other words, how likely a patient is to acutely reject their new transplant. Therefore, it is essential that HLA and PRA statuses are tested for and demonstrate low immunoreactivity of the patient to the graft. In some cases, a recipient may suffer from
1089:
tolerated. Most patients are weaned from PN within 4 weeks of transplantation, and nearly all are free from additional enteral supplementation by one year. Evidence for the restoration of function includes decreasing gastrostomy tube returns and increasing
992:
are especially difficult and susceptible to complications because all organs must survive a conjoined procurement, transport, and transplantation. All three of these measures are tailored to the individual needs of the recipient. Preservation of the native
1213:. Following transplantation, these have been found to generally decrease. According to surveys comparing patients who have undergone transplants and those that have not, there seems to be a remarkable improvement for transplant recipients in such areas as
760:
Following matching of the organ, the complicated procurement of the small bowel can be performed by a team of abdominal transplant surgeons. Once a donor has been selected and approved for donation, several pretreatments may be initiated to destroy
3038:
934:. However, venous drainage, or the reattachment of the transplanted organ to the venous system, may be performed differently depending on the unique intra-abdominal vasculature of the recipient. The graft is usually drained systemically into the
1094:
through the first post-transplant year, the ileostomy would generally be closed. Should rejection be suspected in the future, endoscopies would be performed and an appropriate antirejection therapy will be tailored. The median time for hospital
525:(ITR), where they contribute to the world's growing understanding of intestine transplantation. Before a transplant may be performed, an organ must first be located. In the United States, the matching of all organs is coordinated by the
1772:
Frongia, Giovanni; Kessler, Markus; Weih, Sandra; Nickkholgh, Arash; Mehrabi, Arianeb; Holland-Cunz, Stefan (2013). "Comparison of LILT and STEP procedures in children with short bowel syndrome – A systematic review of the literature".
162:
attempted the first human intestinal transplant, albeit unsuccessfully. For the next two decades, attempts at transplanting the small intestine in humans were met with universal failure, and patients died of technical complications,
410:
preparations should be made for the transplant team and patient as well. Early referral requires trust between all parties involved in the operation to ensure that a rush to judgment does not lead to a premature transplant.
1076:
is occasionally performed for the first 5 to 10 days following transplant to improve intestinal circulation and a potential dispensing of immunosuppressive effects. The gut is selectively decontaminated against high-risk
378:-associated life-threatening sepsis, fluid and electrolyte abnormalities in the face of maximal medical therapy, and PN-associated liver disease. Transplants may also be performed if the growth and development of a
857:, cutting off blood supply to the organs. Once blood and oxygen supply to an organ is cut off, organ death will approach swiftly unless steps are taken to preserve them until transplant. Organs are therefore fully
486:
may be included in the graft. Multivisceral grafts are considered when the underlying condition significantly compromises other sections of the digestive system, such as intra-abdominal tumors that have not yet
1129:
difficult, especially as both ciclosporin (14–36%) and tacrolimus (8.5–22%) have generally low bioavailabilities. A major problem due to immunosuppression in intestinal transplant patients is post-transplant
326:
can be significantly decreased. On average, PN takes 10 to 16 hours to administer but can take up to 24. Over this time frame, daily life can be significantly hindered as a consequence of attachment to the
1098:
varies between procedures. The median times for isolated intestine, intestine-liver, and multivisceral transplants are 30, 60, and 40 days post-operation respectively. Within the first several months,
557:
and bodily metabolism allows for healthier organs for procurement and additional time to prepare recipients for transplant. Furthermore, terminal ileum recovery from living donors is possible., and a
1178:. Very young (<1 year) and very old (>60 years) patients receiving a transplant have pronounced rates of mortality. After 4 years, pediatric survival significantly worsens compared to adults.
820:
Once donor preparation is accomplished, procurement can begin by utilizing the same standard techniques for all abdominal organ procurements. The team exposes the abdominal cavity and inserts two
2275:
Abu-Elmagd, Kareem; Fung, John; Bueno, Javier; Martin, Dolly; Madariaga, Juan R.; Mazariegos, George; Bond, Geoffrey; Molmenti, Ernesto; Corry, Robert J.; Starzl, Thomas E.; Reyes, Jorge (2000).
561:
is being developed to harvest limited sections of small bowel from living donors. When determining potential donor-recipient matches, important characteristics include donor size, age,
950:. The graft is then reperfused with blood and any bleeding is stopped before the proximal and distal ends of the transplant bowel are connected to the original digestive tract. A loop
3153:
2232:
Kim, W.W.; Gagner, M.; Fukuyama, S.; Hung, T.I.; Biertho, L.; Jacob, B.P.; Gentileschi, P. (2002). "Laparoscopic harvesting of small bowel graft for small bowel transplantation".
3477:
180:, appeared on the market as a superior alternative to ciclosporin. In the two decades since, intestine transplant efforts have improved tremendously in both number and outcomes.
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transplants at experienced transplant centers, and who receive antibody or sirolimus-based induction therapies have increased rates of survival. Furthermore, underlying
347:
4378:
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viable, and logistical challenges are faced regarding bringing organ and recipient together. During procurement, organs that are being recovered are cooled and
339:-related infections, and liver disease. PN-associated liver disease strikes up to 50% of patients within 5–7 years, correlated with a mortality rate of 2–50%.
438:
for intestine transplantation; desperate terminal patients may accept a transplant from a HIV-positive donor if they are willing to expose themselves to HIV.
2988:
517:
intestines, like all organs, should be matched to a recipient prior to recovery, as to prepare him or her and minimize the time the organ spends outside the
4175:
2065:
Yersiz, Hasan; Renz, John F.; Hisatake, Garrett M.; Gordon, Sherylin; Saggi, Bob H.; Feduska, Nicholas J.; Busuttil, Ronald W.; Farmer, Douglas G. (2003).
382:
patient fails to ensue, or in extreme circumstances for patients with an exceptionally low quality of life on PN. A multidisciplinary team consisting of
930:
ends of the digestive tract. Anastomosis is then performed to revascularize the graft. Arterial vessels are connected to the abdominal aorta, below the
4180:
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2719:
1253:
Receiving an organ transplant of any kind is a highly significant investment financially, but a successful, well-functioning transplant can be very
4073:
2809:
73:
2445:
Hebert, M (1997). "Contributions of hepatic and intestinal metabolism and P-glycoprotein to cyclosporine and tacrolimus oral drug delivery".
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2160:
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led by
Richard C. Lillehei reported successful transplantation of the small intestine in dogs. Five years later in 1964, Ralph Deterling in
3628:
3463:
1602:
Grant, David; Abu-Elmagd, Kareem; Reyes, Jorge; Tzakis, Andreas; Langnas, Alan; Fishbein, Thomas; Goulet, Olivier; Farmer, Douglas (2005).
980:. Following this, the aorta, cava, and portal veins of the donor and recipient are anastomosed. The graft is then flushed before the caval
894:. The protocols for combined liver and multivisceral procurements are far more complicated and meticulous than isolated intestine alone.
3677:
3251:
3132:
3127:
2739:
1979:"Intestinal Replacement Therapy: Timing and Indications for Referral of Patients to an Intestinal Rehabilitation and Transplant Program"
1360:"The effects of long-term total parenteral nutrition on gut mucosal immunity in children with short bowel syndrome: a systematic review"
997:, pancreas, and duodenum during a multivisceral transplant can reduce the risk of additional complications related to these structures.
2695:
1021:
levels measured for evidence of intestinal ischemia. The patient's immune system is strongly modulated immediately post-operation. The
142:
transplantation performed, intestine transplantation is becoming increasingly prevalent as a therapeutic option due to improvements in
4115:
1886:
Vianna, Rodrigo M.; Mangus, Richard S.; Tector, A. Joseph (2008). "Current Status of Small Bowel and
Multivisceral Transplantation".
1433:
Buchman, Alan L.; Scolapio, James; Fryer, Jon (2003). "AGA technical review on short bowel syndrome and intestinal transplantation".
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4373:
4368:
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2040:
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and transit time, and therefore the length of the allograft determines the immunosuppression regimen. Intravenous administration of
522:
3058:
3043:
2774:
597:
526:
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deficiencies, or other underlying factors, the liver may be transplanted along with the intestine. In a multivisceral graft, the
2396:
Khan, K. M.; Desai, C. S.; Mete, M.; Desale, S.; Girlanda, R.; Hawksworth, J.; Matsumoto, C.; Kaufman, S.; Fishbein, T. (2014).
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3172:
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3613:
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3177:
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recognizing the transplanted organ as foreign. This is the most notable complication facing transplant recipients. Through
466:
are transplanted. These are performed in the absence of liver failure. In the event of severe liver dysfunction due to PN,
458:
organs may be transplanted as well. In the most basic and common graft, an isolated intestinal graft, only sections of the
3995:
3739:
3053:
3033:
232:. Many underlying conditions that serve as precursors to failure are genetic or congenital in nature. For example, severe
212:
will be dismal. Causes of intestinal failure may be clinically complex, and may result from a combination of nutritional,
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3980:
3807:
3753:
3684:
3513:
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are removed. The intestine is then reconstructed as in an isolated intestinal transplant, before being connected to the
3549:
2687:
2630:
Rovera, Giuseppe M.; DiMartini, Andrea2; Schoen, Robert E.; Rakela, Jorge; Abu-Elmagd, Kareem; Graham, Toby O. (1998).
4170:
4005:
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1567:
1254:
534:
1500:
Mazariegos, G. V.; Steffick, D. E.; Horslen, S.; Farmer, D.; Fryer, J.; Grant, D.; Langnas, A.; Magee, J. C. (2010).
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4000:
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Krawinkel, Michael B; Scholz, Dietmar; Busch, Andreas; Kohl, Martina; Wessel, Lukas M; Zimmer, Klaus-Peter (2012).
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3569:
3559:
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Testa, Giuliano; Panaro, Fabrizio; Schena, Stefano; Holterman, Mark; Abcarian, Herand; Benedetti, Enrico (2004).
1218:
1010:
832:
621:
435:
434:. These criteria are similar to established guidelines for transplants of other organ types. HIV infection is a
415:
314:
individual can obtain nutrients intravenously through PN, bypassing food consumption entirely and its subsequent
270:
50:. The prior removal of sections of small intestine for treatment of precursor conditions is the primary cause of
861:, flushed with cool preservation solution, and removed from the body. In an isolated intestinal transplant, the
4360:
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cut to create a vascular cuff. The complete intestinal allograft can then be removed and wrapped in a surgical
840:
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359:
201:
989:
976:
When a liver is being transplanted in conjunction with the intestine, the recipient must first have their own
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should be consulted to evaluate the treatment plan and ensure transplantation is the patient's best option.
155:
2277:"Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor"
673:
342:
Another alternative treatment to transplant for patients with SBS is surgical bowel lengthening via either
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to the kidneys. A transplant recipient must remain on immunosuppressants for the rest of his or her life.
814:
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278:
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423:
367:
107:
4383:
1566:. In Ameh, Emmanuel A.; Bickler, Stephen W.; Lakhoo, Kokila; Nwomeh, Benedict C.; Poenaru, Dan (eds.).
533:. In terms of transplant outcomes, brain-dead donors are highly preferable to donors who have suffered
612:(PRA) test measures the proportion of the population to which a recipient will react via pre-existing
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1133:, in which B-lymphocytes excessively proliferate due to infection by EBV and result in infectious
718:
compromise the next largest cohort, followed by pediatric patients aged 6 and older. In 2008, the
3780:
3623:
3200:
2427:
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1959:
1682:
1238:
854:
608:. Once identified as foreign, the immune system proceeds to destroy the transplanted tissue. The
570:
387:
383:
253:
902:
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2129:
2108:"Living-related intestinal transplantation: first report of a standardized surgical technique"
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1951:
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Lao, O. B.; Healey, P. J.; Perkins, J. D.; Horslen, S.; Reyes, J. D.; Goldin, A. B. (2010).
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262:
119:
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Todo, Satoru; Tzakis, Andreas; Abu-Elmagd, Kareem; Reyes, Jorge; Starzl, Thomas E. (1994).
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are administered on an individual patient basis to further suppress the immune system. The
146:, surgical technique, PN, and the clinical management of pre and post-transplant patients.
17:
4388:
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Koletzko, Berthold; Goulet, Olivier; Hunt, Joanne; Krohn, Kathrin; Shamir, Raanan (2005).
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should be collected and tested in the laboratory. In addition to HLA and PRA typing, the
331:. Over long periods of time, PN can lead to numerous health conditions, including severe
694:
procurement and the restoration of physiological temperature during implantation is the
126:. While intestinal failure can oftentimes be treated with alternative therapies such as
4393:
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4083:
4028:
3734:
3704:
3598:
3539:
3522:
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3013:
2949:
2607:
2582:
2558:
2533:
2506:
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2200:
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3534:
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2107:
1963:
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1134:
1030:
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131:
123:
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1049:
981:
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233:
188:
Failure of the small intestine is life-threatening due to the inability to absorb
1995:
1978:
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3028:
2967:
1187:
1142:
1082:
1045:
1018:
977:
967:
935:
919:
882:, where the vessels converge out of the intestinal system. This pedicle will be
874:
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802:
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636:
627:
To ensure proper histocompatibility, tissue quality, and safety from infection,
558:
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1041:
1037:
963:
850:
794:
774:
739:
628:
613:
554:
538:
518:
492:
488:
379:
266:
237:
229:
221:
177:
2497:
1137:-like lesions. Intestinal transplant recipients are also at risk for chronic
446:
There are three major types of intestine transplants: an isolated intestinal
154:
Intestine transplantation dates back to 1959, when a team of surgeons at the
4131:
3934:
3845:
3835:
3792:
3722:
3526:
2714:
2083:
2066:
1473:
1414:
1343:
1226:
1210:
1175:
1078:
1061:
985:
955:
951:
915:
862:
719:
690:
503:
447:
391:
315:
213:
209:
2616:
2567:
2549:
2515:
2466:
2423:
2379:
2310:
2253:
2218:
2092:
2004:
1955:
1907:
1810:"Longitudinal intestinal lengthening and tailoring: results in 20 children"
1794:
1758:
1678:
1637:
1538:
1454:
1395:
138:
may make transplantation the only viable option. One of the rarest type of
41:
2657:
2352:
Pascher, Andreas; Kohler, Sven; Neuhaus, Peter; Pratschke, Johann (2008).
2133:
1947:
1843:
1376:
1301:
879:
200:
from food. Without these essential substances and the ability to maintain
82:
4202:
3943:
3419:
3106:
1530:
1234:
1207:
1195:
1183:
1158:
923:
825:
778:
653:
624:, in which cells of the transplanted organ attack the recipient's cells.
499:
479:
475:
375:
363:
336:
294:
189:
2724:
370:
for intestine transplantation: a loss of two of the six major routes of
3579:
1214:
845:
821:
657:
617:
601:
471:
459:
455:
225:
176:
rather a life-saving therapy. In 1990, a newer immunosuppressant drug,
104:
2414:
2397:
2354:"Present status and future perspectives of intestinal transplantation"
1731:
Garg, Mayur; Jones, Robert M; Vaughan, Rhys B; Testro, Adam G (2011).
853:
so that they may be quickly extracted. In the next step, the aorta is
529:(UNOS). The standard intestinal donor is deceased with a diagnosis of
4296:
3860:
994:
959:
931:
927:
748:
699:
680:
infections, organ transplantation is not without extrasurgical risk.
677:
496:
467:
164:
159:
305:
710:, cannot find a transplant due to the lack of size-matched donors.
4065:
1733:"Intestinal transplantation: Current status and future directions"
1146:
1029:
to suppress T-lymphocyte activation. Next, various assortments of
901:
891:
866:
836:
715:
542:
463:
304:
290:
193:
47:
1005:
Following the procedure, the patient is actively monitored in an
592:
are able to distinguish between self and non-self by recognizing
3086:
2703:
2022:
2020:
2018:
2016:
2014:
911:
371:
3459:
2728:
2632:"Quality of life of patients after intestinal transplantation"
2067:"Multivisceral and isolated intestinal procurement techniques"
418:
to receiving an intestinal transplant include the presence of
318:. Long-term survival with SBS and without PN is possible with
1559:
Mears, Alice; Lakhoo, Kokila; Millar, Alastair J. W. (2010).
580:
Organ rejection is the unfortunate circumstance of the host
1502:"Intestine Transplantation in the United States, 1999–2008"
1014:
707:
2151:
Twice dead: Organ transplants and the reinvention of death
1934:
1333:
1331:
873:
are devascularized, while care is taken to preserve major
722:
composition of the intestinal transplant waitlist was 65%
2398:"Developing Trends in the Intestinal Transplant Waitlist"
1495:
1493:
1491:
1489:
1487:
1485:
1483:
1481:
1329:
1327:
1325:
1323:
1321:
1319:
1317:
1315:
1313:
1311:
422:
and untreated local infections, malignant cancer, severe
553:
function. If appropriately managed, the continuation of
2033:
Surgical
Treatment: Evidence-Based and Problem-Oriented
1881:
1879:
1877:
1875:
1873:
914:
from previous surgeries must be removed. The aorta and
54:(SBS), the leading cause of intestinal transplantation.
2060:
2058:
2056:
2054:
2052:
1871:
1869:
1867:
1865:
1863:
1861:
1859:
1857:
1855:
1853:
1428:
1426:
1424:
1422:
2178:
2176:
2174:
2172:
1726:
1724:
1722:
1720:
1718:
1716:
954:
is then created as to provide easy access for future
2391:
2389:
1714:
1712:
1710:
1708:
1706:
1704:
1702:
1700:
1698:
1696:
1597:
1595:
1593:
1591:
1589:
1554:
1552:
1550:
1548:
4359:
4327:
4295:
4252:
4243:
4201:
4126:
4064:
4055:
4019:
3925:
3887:
3859:
3821:
3761:
3752:
3713:
3578:
3521:
3512:
3503:
3402:
3354:
3338:
3322:
3291:
3265:
3229:
3193:
3186:
3141:
3115:
3067:
3002:
2976:
2948:
2920:
2795:
2762:
2527:
2525:
2027:Troppmann, Christoph; Gruessne, Rainer W G (2001).
1657:
Journal of
Pediatric Gastroenterology and Nutrition
1569:
Paediatric
Surgery: A Comprehensive Text For Africa
973:may be placed before the abdominal wall is closed.
67:
59:
34:
2534:"Outcomes in Children After Intestinal Transplant"
2148:
1604:"2003 Report of the Intestine Transplant Registry"
1025:consists of the administration of tacrolimus with
171:. However, the discovery of the immunosuppressant
2106:Gruessner, Rainer W.G.; Sharp, Harvey L. (1997).
2031:. In Holzheimer, René G; Mannick, John A (eds.).
1929:
1927:
1925:
1923:
1921:
1919:
1917:
886:closed, and can be separated from the body via a
348:longitudinal intestinal lengthening and tailoring
184:Pre-transplant diagnoses and short bowel syndrome
2720:Intestinal Transplant for Crohn's Disease, WebMD
1013:are administered, bleeding monitored, and serum
1977:Fishbein, Thomas M.; Matsumoto, Cal S. (2006).
702:damage and bacterial translocation outside the
3390:List of organ transplant donors and recipients
2322:
2320:
1276:"Current status of intestinal transplantation"
1116:material consumed by the body, the intestinal
309:Prescription parenteral nutrition formulation.
4111:Transjugular intrahepatic portosystemic shunt
3471:
2740:
541:, brain-dead donors may exhibit maintainable
8:
2989:Post-transplant lymphoproliferative disorder
2185:"Living Related Small Bowel Transplantation"
1353:
1351:
1085:is taken against CMV and fungal infections.
523:International Intestinal Transplant Registry
2670:: CS1 maint: numeric names: authors list (
450:, a combined intestinal-liver graft, and a
27:Surgical replacement of the small intestine
4249:
4061:
3758:
3518:
3509:
3478:
3464:
3456:
3190:
2747:
2733:
2725:
1737:Journal of Gastroenterology and Hepatology
1068:of these drugs is dependent on intestinal
918:are dissected in preparation for vascular
130:(PN), complications such as PN-associated
2647:
2606:
2557:
2505:
2413:
2369:
2300:
2208:
2123:
2082:
1994:
1833:
1748:
1668:
1627:
1520:
1385:
1375:
1291:
521:. Potential recipients are placed on the
3917:Transanal hemorrhoidal dearterialization
2583:"Chronic intestinal failure in children"
2480:O'Hara, Ann M; Shanahan, Fergus (2006).
1814:Journal of the Royal Society of Medicine
4074:Artificial extracorporeal liver support
1266:
402:, financial representatives, and other
2663:
906:Isolated intestine transplant diagram.
809:directed against excessive mesenteric
537:. If respiration can be assisted by a
31:
843:. As the abdominal organs are cooled
793:. They may also be treated with anti-
7:
3629:Vertical banded gastroplasty surgery
2693:Partnering With Your Transplant Team
2482:"The gut flora as a forgotten organ"
269:conditions such as Crohn's disease,
3678:Percutaneous endoscopic gastrostomy
3486:Tests and procedures involving the
3133:Canadian Society of Transplantation
3128:American Society of Transplantation
2402:American Journal of Transplantation
1509:American Journal of Transplantation
938:vena cava, but may also be drained
224:complications that affect ordinary
78:
4116:Distal splenorenal shunt procedure
2587:Deutsches Ă„rzteblatt International
2329:Clinical guide to laboratory tests
2201:10.1097/01.sla.0000143266.59408.d7
2155:. University of California Press.
1670:10.1097/01.mpg.0000181841.07090.f4
1620:10.1097/01.sla.0000157265.85388.a1
25:
3059:United Network for Organ Sharing
3044:National Transplant Organization
2649:10.1097/00007890-199811150-00005
2371:10.1111/j.1432-2277.2008.00637.x
2293:10.1097/00000658-200011000-00010
2125:10.1097/00007890-199712150-00019
1750:10.1111/j.1440-1746.2011.06783.x
1522:10.1111/j.1600-6143.2010.03044.x
922:, followed by dissection of the
604:located on the surface of organ
598:major histocompatibility complex
577:by the body is all but certain.
527:United Network for Organ Sharing
40:
3907:Lateral internal sphincterotomy
3173:Organ transplantation in Israel
1936:New England Journal of Medicine
1572:. Global Help. pp. 424–8.
208:cannot be maintained and one's
3614:Endoscopic sleeve gastroplasty
3565:Functional Lumen Imaging Probe
3178:Organ transplantation in Japan
3149:Organ transplantation in China
3123:American Society of Nephrology
2447:Advanced Drug Delivery Reviews
1787:10.1016/j.jpedsurg.2013.05.018
1165:Transplant outcomes and impact
1048:), anti-proliferation agents (
865:from the small intestine. The
769:. The donor intestine must be
684:Waitlist and donation outcomes
344:serial transverse enteroplasty
1:
3996:Lower gastrointestinal series
3740:Upper gastrointestinal series
3054:Trillium Gift of Life Network
3034:National Marrow Donor Program
2459:10.1016/S0169-409X(97)00043-4
1447:10.1016/S0016-5085(03)70064-X
1120:possesses a highly developed
4262:Diagnostic peritoneal lavage
3981:Double-contrast barium enema
3808:Partial ileal bypass surgery
3685:Esophagogastric dissociation
3092:Halachic Organ Donor Society
3019:Gift of Life Marrow Registry
2029:"Intestinal transplantation"
1996:10.1053/j.gastro.2005.12.004
1775:Journal of Pediatric Surgery
1131:lymphoproliferative disorder
849:, the surrounding tissue is
4079:Bioartificial liver devices
4006:Transrectal ultrasonography
3097:Kidney Foundation of Canada
878:attached by the mesenteric
833:organ preservation solution
101:small bowel transplantation
97:intestinal transplantation,
63:Small bowel transplantation
18:Small bowel transplantation
4441:
4001:Small-bowel follow-through
3869:Abdominoperineal resection
3728:Esophagogastroduodenoscopy
3154:harvesting from Falun Gong
3102:National Kidney Foundation
2958:Non-heart-beating donation
2710:Intestinal Transplantation
2327:Tietz, Norbert W. (1995).
2147:Lock, Margaret M. (2002).
1900:10.1016/j.yasu.2008.03.008
1826:10.1177/014107689709000804
1339:Intestinal Transplantation
1023:initial phase of treatment
1011:Broad-spectrum antibiotics
506:, and motility syndromes.
416:absolute contraindications
252:, or other pathologies of
144:immunosuppressive regimens
4361:Clinical prediction rules
4267:Intraperitoneal injection
3971:Abdominal ultrasonography
3879:Total mesorectal excision
3798:Intestine transplantation
3588:Sengstaken–Blakemore tube
3570:High resolution manometry
3560:Esophageal motility study
3494:
3385:
2984:Graft-versus-host disease
2599:10.3238/arztebl.2012.0409
2246:10.1007/s00464-001-8249-9
990:Multivisceral transplants
988:servicing the new liver.
622:graft-versus-host disease
436:relative contraindication
271:necrotizing enterocolitis
93:Intestine transplantation
79:
39:
35:Intestine transplantation
4415:Digestive system surgery
4216:Pancreas transplantation
3874:Lower anterior resection
3555:Esophageal pH monitoring
3497:Digestive system surgery
3049:NHS Blood and Transplant
2498:10.1038/sj.embor.7400731
2358:Transplant International
2035:. Munich: Zuckschwerdt.
1249:Financial considerations
1111:Biological complications
948:superior mesenteric vein
898:Transplantation protocol
841:inferior mesenteric vein
641:complete metabolic panel
594:human leukocyte antigens
4310:Inguinal hernia surgery
4226:Pancreaticoduodenectomy
3609:Adjustable gastric band
3550:Impedance–pH monitoring
3425:Immunosuppressive drugs
3161:Organ donation in India
2084:10.1053/jlts.2003.50155
830:University of Wisconsin
813:, and have their bowel
799:anti-thymocyte globulin
610:panel-reactive antibody
424:neurological impairment
374:, multiple episodes of
156:University of Minnesota
4340:Exploratory laparotomy
4155:Hepatoportoenterostomy
3619:Gastric bypass surgery
3488:human digestive system
3445:Frankenstein's monster
3440:Total body irradiation
3166:Gurgaon kidney scandal
3024:Human Tissue Authority
2550:10.1542/peds.2009-1713
1989:(2 Suppl 1): S147–51.
1561:"Short Bowel Syndrome"
1358:Duran, Beyhan (2005).
907:
863:colon will be detached
704:gastrointestinal tract
559:laparoscopic technique
310:
301:Alternative treatments
4425:Organ transplantation
4315:Femoral hernia repair
4101:Liver transplantation
3695:Nissen fundoplication
3430:Lung allocation score
3367:Jean-Michel Dubernard
2756:Organ transplantation
2071:Liver Transplantation
1948:10.1056/NEJMra0804605
1377:10.1186/1472-6955-4-2
1241:, and the quality of
1054:mycophenolate mofetil
1001:Post-operative period
910:First, any abdominal
905:
535:cardiopulmonary death
308:
3912:Rubber band ligation
3851:Hartmann's operation
3237:J. Hartwell Harrison
2994:Transplant rejection
1469:Short-Bowel Syndrome
1194:enteral nutritional
1172:lung transplantation
1122:innate immune system
756:Procurement protocol
738:, and 0.5% other or
656:for the presence of
633:complete blood count
510:Pre-operative period
346:(STEP) or the older
259:short bowel syndrome
136:short bowel syndrome
128:parenteral nutrition
122:cases of intestinal
52:short bowel syndrome
4287:Peritoneal dialysis
4106:Portal hypertension
4011:Virtual colonoscopy
3986:Endoanal ultrasound
3902:Anorectal manometry
3897:Anal sphincterotomy
3841:Colonic polypectomy
3636:Collis gastroplasty
3346:André van der Merwe
3330:Richard C. Lillehei
3003:Transplant networks
2787:Xenotransplantation
2782:Autotransplantation
2770:Allotransplantation
2698:3 June 2015 at the
1888:Advances in Surgery
1808:Bianchi, A (1997).
1515:(4 Pt 2): 1020–34.
1280:Advances in Surgery
1007:intensive care unit
596:(HLA) bound to the
571:histo-compatibility
491:, extensive venous
452:multivisceral graft
388:gastroenterologists
384:transplant surgeons
275:mesenteric ischemia
263:gastroenterological
3781:Jejunoileal bypass
3624:Sleeve gastrectomy
3201:Christiaan Barnard
2797:Organs and tissues
2234:Surgical Endoscopy
1663:(Suppl 2): S1–87.
1239:medical compliance
1186:, the presence of
1126:antigen-presenting
908:
696:cold ischemic time
674:Epstein–Barr virus
311:
46:Resected diseased
4402:
4401:
4347:Rapid urease test
4323:
4322:
4239:
4238:
4231:Puestow procedure
4193:Cholescintigraphy
4051:
4050:
4047:
4046:
4039:Stool guaiac test
3949:Capsule endoscopy
3771:Bariatric surgery
3748:
3747:
3663:Gastroenterostomy
3604:Bariatric surgery
3453:
3452:
3435:Machine perfusion
3415:Edmonton protocol
3410:Biomedical tissue
3398:
3397:
3309:Vladimir Demikhov
3211:Adrian Kantrowitz
2963:Organ procurement
2688:Transplant Living
2593:(22–23): 409–15.
2415:10.1111/ajt.12919
2338:978-0-7216-5035-7
2281:Annals of Surgery
2189:Annals of Surgery
2162:978-0-520-22814-6
1608:Annals of Surgery
1579:978-1-60189-091-7
1083:preventative care
1056:), and the drugs
742:, resembling the
660:, including HIV,
432:pulmonary disease
396:anesthesiologists
320:enteral nutrition
279:motility disorder
242:bowel obstruction
90:
89:
16:(Redirected from
4432:
4420:Gastroenterology
4384:Child–Pugh score
4351:Urea breath test
4250:
4211:Frey's procedure
4188:Cholecystography
4062:
3759:
3594:Nasogastric tube
3519:
3510:
3480:
3473:
3466:
3457:
3257:Michael Woodruff
3191:
2922:Medical grafting
2749:
2742:
2735:
2726:
2676:
2675:
2669:
2661:
2651:
2627:
2621:
2620:
2610:
2578:
2572:
2571:
2561:
2529:
2520:
2519:
2509:
2477:
2471:
2470:
2453:(2–3): 201–214.
2442:
2436:
2435:
2417:
2393:
2384:
2383:
2373:
2349:
2343:
2342:
2324:
2315:
2314:
2304:
2272:
2266:
2265:
2229:
2223:
2222:
2212:
2180:
2167:
2166:
2154:
2144:
2138:
2137:
2127:
2103:
2097:
2096:
2086:
2062:
2047:
2046:
2024:
2009:
2008:
1998:
1983:Gastroenterology
1974:
1968:
1967:
1942:(10): 998–1008.
1931:
1912:
1911:
1883:
1848:
1847:
1837:
1805:
1799:
1798:
1769:
1763:
1762:
1752:
1728:
1691:
1690:
1672:
1648:
1642:
1641:
1631:
1599:
1584:
1583:
1565:
1556:
1543:
1542:
1524:
1506:
1497:
1476:
1465:
1459:
1458:
1435:Gastroenterology
1430:
1417:
1406:
1400:
1399:
1389:
1379:
1355:
1346:
1335:
1306:
1305:
1295:
1271:
1074:prostaglandin E1
1058:cyclophosphamide
958:observation and
859:drained of blood
811:lymphatic tissue
586:T-cell receptors
442:Transplant types
83:edit on Wikidata
44:
32:
21:
4440:
4439:
4435:
4434:
4433:
4431:
4430:
4429:
4405:
4404:
4403:
4398:
4389:Ranson criteria
4355:
4319:
4291:
4235:
4197:
4166:Cholangiography
4162:Medical imaging
4145:Cholecystostomy
4140:Cholecystectomy
4122:
4043:
4015:
3927:Medical imaging
3921:
3883:
3855:
3817:
3813:Strictureplasty
3788:Bowel resection
3776:Duodenal switch
3744:
3715:Medical imaging
3709:
3574:
3505:Digestive tract
3499:
3490:
3484:
3454:
3449:
3394:
3381:
3350:
3334:
3318:
3287:
3261:
3242:John P. Merrill
3225:
3182:
3137:
3116:Joint societies
3111:
3082:Blood Cancer UK
3069:
3063:
3006:
3004:
2998:
2972:
2944:
2940:Vascular bypass
2916:
2791:
2758:
2753:
2700:Wayback Machine
2684:
2679:
2662:
2636:Transplantation
2629:
2628:
2624:
2580:
2579:
2575:
2531:
2530:
2523:
2479:
2478:
2474:
2444:
2443:
2439:
2395:
2394:
2387:
2351:
2350:
2346:
2339:
2331:. WB Saunders.
2326:
2325:
2318:
2274:
2273:
2269:
2231:
2230:
2226:
2182:
2181:
2170:
2163:
2146:
2145:
2141:
2112:Transplantation
2105:
2104:
2100:
2064:
2063:
2050:
2043:
2026:
2025:
2012:
1976:
1975:
1971:
1933:
1932:
1915:
1885:
1884:
1851:
1807:
1806:
1802:
1781:(8): 1794–805.
1771:
1770:
1766:
1730:
1729:
1694:
1650:
1649:
1645:
1601:
1600:
1587:
1580:
1563:
1558:
1557:
1546:
1504:
1499:
1498:
1479:
1466:
1462:
1432:
1431:
1420:
1407:
1403:
1357:
1356:
1349:
1336:
1309:
1273:
1272:
1268:
1264:
1251:
1167:
1145:inhibitors are
1113:
1066:bioavailability
1027:corticosteroids
1003:
900:
871:ascending colon
758:
686:
670:cytomegalovirus
645:ABO blood group
616:to various HLA
575:organ rejection
512:
454:in which other
444:
358:There are four
356:
324:quality of life
303:
254:Crohn's disease
202:energy balances
186:
169:graft rejection
152:
112:small intestine
86:
55:
28:
23:
22:
15:
12:
11:
5:
4438:
4436:
4428:
4427:
4422:
4417:
4407:
4406:
4400:
4399:
4397:
4396:
4394:Milan criteria
4391:
4386:
4381:
4376:
4371:
4365:
4363:
4357:
4356:
4354:
4353:
4344:
4343:
4342:
4331:
4329:
4325:
4324:
4321:
4320:
4318:
4317:
4312:
4307:
4301:
4299:
4293:
4292:
4290:
4289:
4284:
4279:
4274:
4269:
4264:
4258:
4256:
4247:
4245:Abdominopelvic
4241:
4240:
4237:
4236:
4234:
4233:
4228:
4223:
4221:Pancreatectomy
4218:
4213:
4207:
4205:
4199:
4198:
4196:
4195:
4190:
4185:
4184:
4183:
4178:
4173:
4158:
4157:
4152:
4147:
4142:
4136:
4134:
4124:
4123:
4121:
4120:
4119:
4118:
4113:
4103:
4098:
4093:
4088:
4087:
4086:
4084:Liver dialysis
4081:
4070:
4068:
4059:
4053:
4052:
4049:
4048:
4045:
4044:
4042:
4041:
4036:
4031:
4029:Fecal fat test
4025:
4023:
4017:
4016:
4014:
4013:
4008:
4003:
3998:
3993:
3988:
3983:
3978:
3973:
3967:
3966:
3961:
3956:
3951:
3946:
3941:
3931:
3929:
3923:
3922:
3920:
3919:
3914:
3909:
3904:
3899:
3893:
3891:
3885:
3884:
3882:
3881:
3876:
3871:
3865:
3863:
3857:
3856:
3854:
3853:
3848:
3843:
3838:
3833:
3827:
3825:
3819:
3818:
3816:
3815:
3810:
3805:
3800:
3795:
3790:
3785:
3784:
3783:
3778:
3767:
3765:
3756:
3754:Lower GI tract
3750:
3749:
3746:
3745:
3743:
3742:
3737:
3735:Barium swallow
3732:
3731:
3730:
3719:
3717:
3711:
3710:
3708:
3707:
3705:Schilling test
3702:
3697:
3692:
3687:
3682:
3681:
3680:
3670:
3665:
3660:
3659:
3658:
3653:
3648:
3638:
3633:
3632:
3631:
3626:
3621:
3616:
3611:
3601:
3599:Gastric lavage
3596:
3591:
3584:
3582:
3576:
3575:
3573:
3572:
3567:
3562:
3557:
3552:
3547:
3542:
3540:Heller myotomy
3537:
3531:
3529:
3516:
3514:Upper GI tract
3507:
3501:
3500:
3495:
3492:
3491:
3485:
3483:
3482:
3475:
3468:
3460:
3451:
3450:
3448:
3447:
3442:
3437:
3432:
3427:
3422:
3417:
3412:
3406:
3404:
3403:Related topics
3400:
3399:
3396:
3395:
3393:
3392:
3386:
3383:
3382:
3380:
3379:
3374:
3369:
3364:
3358:
3356:
3352:
3351:
3349:
3348:
3342:
3340:
3336:
3335:
3333:
3332:
3326:
3324:
3320:
3319:
3317:
3316:
3314:James D. Hardy
3311:
3306:
3304:Joel D. Cooper
3301:
3295:
3293:
3289:
3288:
3286:
3285:
3280:
3278:James D. Hardy
3275:
3269:
3267:
3263:
3262:
3260:
3259:
3254:
3252:Elizabeth Ward
3249:
3244:
3239:
3233:
3231:
3227:
3226:
3224:
3223:
3221:Norman Shumway
3218:
3213:
3208:
3206:James D. Hardy
3203:
3197:
3195:
3188:
3184:
3183:
3181:
3180:
3175:
3170:
3169:
3168:
3158:
3157:
3156:
3145:
3143:
3139:
3138:
3136:
3135:
3130:
3125:
3119:
3117:
3113:
3112:
3110:
3109:
3104:
3099:
3094:
3089:
3084:
3079:
3073:
3071:
3065:
3064:
3062:
3061:
3056:
3051:
3046:
3041:
3036:
3031:
3026:
3021:
3016:
3014:Eurotransplant
3010:
3008:
3005:and government
3000:
2999:
2997:
2996:
2991:
2986:
2980:
2978:
2974:
2973:
2971:
2970:
2965:
2960:
2954:
2952:
2950:Organ donation
2946:
2945:
2943:
2942:
2937:
2932:
2926:
2924:
2918:
2917:
2915:
2914:
2909:
2904:
2899:
2894:
2889:
2884:
2883:
2882:
2872:
2867:
2862:
2857:
2852:
2847:
2842:
2837:
2832:
2827:
2822:
2817:
2812:
2807:
2801:
2799:
2793:
2792:
2790:
2789:
2784:
2779:
2778:
2777:
2766:
2764:
2760:
2759:
2754:
2752:
2751:
2744:
2737:
2729:
2723:
2722:
2717:
2706:
2690:
2683:
2682:External links
2680:
2678:
2677:
2622:
2573:
2521:
2472:
2437:
2408:(12): 2830–7.
2385:
2344:
2337:
2316:
2267:
2240:(12): 1786–9.
2224:
2168:
2161:
2139:
2118:(11): 1605–7.
2098:
2048:
2041:
2010:
1969:
1913:
1849:
1800:
1764:
1692:
1643:
1585:
1578:
1544:
1477:
1460:
1441:(4): 1111–34.
1418:
1401:
1347:
1307:
1265:
1263:
1260:
1255:cost-efficient
1250:
1247:
1217:, depression,
1166:
1163:
1112:
1109:
1002:
999:
944:hepatic portal
899:
896:
787:amphotericin B
771:decontaminated
763:microorganisms
757:
754:
685:
682:
511:
508:
443:
440:
355:
352:
302:
299:
185:
182:
151:
148:
88:
87:
80:
77:
76:
71:
65:
64:
61:
57:
56:
45:
37:
36:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
4437:
4426:
4423:
4421:
4418:
4416:
4413:
4412:
4410:
4395:
4392:
4390:
4387:
4385:
4382:
4380:
4377:
4375:
4372:
4370:
4367:
4366:
4364:
4362:
4358:
4352:
4348:
4345:
4341:
4338:
4337:
4336:
4333:
4332:
4330:
4326:
4316:
4313:
4311:
4308:
4306:
4305:Hernia repair
4303:
4302:
4300:
4298:
4294:
4288:
4285:
4283:
4280:
4278:
4275:
4273:
4270:
4268:
4265:
4263:
4260:
4259:
4257:
4255:
4251:
4248:
4246:
4242:
4232:
4229:
4227:
4224:
4222:
4219:
4217:
4214:
4212:
4209:
4208:
4206:
4204:
4200:
4194:
4191:
4189:
4186:
4182:
4179:
4177:
4174:
4172:
4169:
4168:
4167:
4163:
4160:
4159:
4156:
4153:
4151:
4148:
4146:
4143:
4141:
4138:
4137:
4135:
4133:
4129:
4125:
4117:
4114:
4112:
4109:
4108:
4107:
4104:
4102:
4099:
4097:
4094:
4092:
4089:
4085:
4082:
4080:
4077:
4076:
4075:
4072:
4071:
4069:
4067:
4063:
4060:
4058:
4054:
4040:
4037:
4035:
4034:Fecal pH test
4032:
4030:
4027:
4026:
4024:
4022:
4018:
4012:
4009:
4007:
4004:
4002:
3999:
3997:
3994:
3992:
3989:
3987:
3984:
3982:
3979:
3977:
3974:
3972:
3969:
3968:
3965:
3964:Sigmoidoscopy
3962:
3960:
3957:
3955:
3952:
3950:
3947:
3945:
3942:
3940:
3936:
3933:
3932:
3930:
3928:
3924:
3918:
3915:
3913:
3910:
3908:
3905:
3903:
3900:
3898:
3895:
3894:
3892:
3890:
3886:
3880:
3877:
3875:
3872:
3870:
3867:
3866:
3864:
3862:
3858:
3852:
3849:
3847:
3844:
3842:
3839:
3837:
3834:
3832:
3829:
3828:
3826:
3824:
3820:
3814:
3811:
3809:
3806:
3804:
3801:
3799:
3796:
3794:
3791:
3789:
3786:
3782:
3779:
3777:
3774:
3773:
3772:
3769:
3768:
3766:
3764:
3760:
3757:
3755:
3751:
3741:
3738:
3736:
3733:
3729:
3726:
3725:
3724:
3721:
3720:
3718:
3716:
3712:
3706:
3703:
3701:
3700:Pyloromyotomy
3698:
3696:
3693:
3691:
3688:
3686:
3683:
3679:
3676:
3675:
3674:
3671:
3669:
3666:
3664:
3661:
3657:
3654:
3652:
3649:
3647:
3644:
3643:
3642:
3639:
3637:
3634:
3630:
3627:
3625:
3622:
3620:
3617:
3615:
3612:
3610:
3607:
3606:
3605:
3602:
3600:
3597:
3595:
3592:
3589:
3586:
3585:
3583:
3581:
3577:
3571:
3568:
3566:
3563:
3561:
3558:
3556:
3553:
3551:
3548:
3546:
3543:
3541:
3538:
3536:
3535:Esophagectomy
3533:
3532:
3530:
3528:
3524:
3520:
3517:
3515:
3511:
3508:
3506:
3502:
3498:
3493:
3489:
3481:
3476:
3474:
3469:
3467:
3462:
3461:
3458:
3446:
3443:
3441:
3438:
3436:
3433:
3431:
3428:
3426:
3423:
3421:
3418:
3416:
3413:
3411:
3408:
3407:
3405:
3401:
3391:
3388:
3387:
3384:
3378:
3375:
3373:
3372:Donna Mansell
3370:
3368:
3365:
3363:
3362:Alexis Carrel
3360:
3359:
3357:
3353:
3347:
3344:
3343:
3341:
3337:
3331:
3328:
3327:
3325:
3321:
3315:
3312:
3310:
3307:
3305:
3302:
3300:
3297:
3296:
3294:
3290:
3284:
3283:Thomas Starzl
3281:
3279:
3276:
3274:
3271:
3270:
3268:
3264:
3258:
3255:
3253:
3250:
3248:
3247:Joseph Murray
3245:
3243:
3240:
3238:
3235:
3234:
3232:
3228:
3222:
3219:
3217:
3216:Richard Lower
3214:
3212:
3209:
3207:
3204:
3202:
3199:
3198:
3196:
3192:
3189:
3185:
3179:
3176:
3174:
3171:
3167:
3164:
3163:
3162:
3159:
3155:
3152:
3151:
3150:
3147:
3146:
3144:
3140:
3134:
3131:
3129:
3126:
3124:
3121:
3120:
3118:
3114:
3108:
3105:
3103:
3100:
3098:
3095:
3093:
3090:
3088:
3085:
3083:
3080:
3078:
3077:Anthony Nolan
3075:
3074:
3072:
3070:organizations
3066:
3060:
3057:
3055:
3052:
3050:
3047:
3045:
3042:
3040:
3037:
3035:
3032:
3030:
3027:
3025:
3022:
3020:
3017:
3015:
3012:
3011:
3009:
3001:
2995:
2992:
2990:
2987:
2985:
2982:
2981:
2979:
2977:Complications
2975:
2969:
2966:
2964:
2961:
2959:
2956:
2955:
2953:
2951:
2947:
2941:
2938:
2936:
2935:Skin grafting
2933:
2931:
2930:Bone grafting
2928:
2927:
2925:
2923:
2919:
2913:
2910:
2908:
2905:
2903:
2900:
2898:
2895:
2893:
2890:
2888:
2885:
2881:
2878:
2877:
2876:
2873:
2871:
2868:
2866:
2863:
2861:
2858:
2856:
2853:
2851:
2848:
2846:
2843:
2841:
2838:
2836:
2833:
2831:
2828:
2826:
2823:
2821:
2818:
2816:
2813:
2811:
2808:
2806:
2803:
2802:
2800:
2798:
2794:
2788:
2785:
2783:
2780:
2776:
2773:
2772:
2771:
2768:
2767:
2765:
2761:
2757:
2750:
2745:
2743:
2738:
2736:
2731:
2730:
2727:
2721:
2718:
2716:
2712:
2711:
2707:
2705:
2701:
2697:
2694:
2691:
2689:
2686:
2685:
2681:
2673:
2667:
2659:
2655:
2650:
2645:
2642:(9): 1141–5.
2641:
2637:
2633:
2626:
2623:
2618:
2614:
2609:
2604:
2600:
2596:
2592:
2588:
2584:
2577:
2574:
2569:
2565:
2560:
2555:
2551:
2547:
2544:(3): e550–8.
2543:
2539:
2535:
2528:
2526:
2522:
2517:
2513:
2508:
2503:
2499:
2495:
2492:(7): 688–93.
2491:
2487:
2483:
2476:
2473:
2468:
2464:
2460:
2456:
2452:
2448:
2441:
2438:
2433:
2429:
2425:
2421:
2416:
2411:
2407:
2403:
2399:
2392:
2390:
2386:
2381:
2377:
2372:
2367:
2364:(5): 401–14.
2363:
2359:
2355:
2348:
2345:
2340:
2334:
2330:
2323:
2321:
2317:
2312:
2308:
2303:
2298:
2294:
2290:
2286:
2282:
2278:
2271:
2268:
2263:
2259:
2255:
2251:
2247:
2243:
2239:
2235:
2228:
2225:
2220:
2216:
2211:
2206:
2202:
2198:
2195:(5): 779–84.
2194:
2190:
2186:
2179:
2177:
2175:
2173:
2169:
2164:
2158:
2153:
2152:
2143:
2140:
2135:
2131:
2126:
2121:
2117:
2113:
2109:
2102:
2099:
2094:
2090:
2085:
2080:
2076:
2072:
2068:
2061:
2059:
2057:
2055:
2053:
2049:
2044:
2042:3-88603-714-2
2038:
2034:
2030:
2023:
2021:
2019:
2017:
2015:
2011:
2006:
2002:
1997:
1992:
1988:
1984:
1980:
1973:
1970:
1965:
1961:
1957:
1953:
1949:
1945:
1941:
1937:
1930:
1928:
1926:
1924:
1922:
1920:
1918:
1914:
1909:
1905:
1901:
1897:
1893:
1889:
1882:
1880:
1878:
1876:
1874:
1872:
1870:
1868:
1866:
1864:
1862:
1860:
1858:
1856:
1854:
1850:
1845:
1841:
1836:
1831:
1827:
1823:
1820:(8): 429–32.
1819:
1815:
1811:
1804:
1801:
1796:
1792:
1788:
1784:
1780:
1776:
1768:
1765:
1760:
1756:
1751:
1746:
1743:(8): 1221–8.
1742:
1738:
1734:
1727:
1725:
1723:
1721:
1719:
1717:
1715:
1713:
1711:
1709:
1707:
1705:
1703:
1701:
1699:
1697:
1693:
1688:
1684:
1680:
1676:
1671:
1666:
1662:
1658:
1654:
1647:
1644:
1639:
1635:
1630:
1625:
1621:
1617:
1614:(4): 607–13.
1613:
1609:
1605:
1598:
1596:
1594:
1592:
1590:
1586:
1581:
1575:
1571:
1570:
1562:
1555:
1553:
1551:
1549:
1545:
1540:
1536:
1532:
1531:2027.42/79108
1528:
1523:
1518:
1514:
1510:
1503:
1496:
1494:
1492:
1490:
1488:
1486:
1484:
1482:
1478:
1475:
1471:
1470:
1464:
1461:
1456:
1452:
1448:
1444:
1440:
1436:
1429:
1427:
1425:
1423:
1419:
1416:
1412:
1411:
1410:Crohn Disease
1405:
1402:
1397:
1393:
1388:
1383:
1378:
1373:
1369:
1365:
1361:
1354:
1352:
1348:
1345:
1341:
1340:
1334:
1332:
1330:
1328:
1326:
1324:
1322:
1320:
1318:
1316:
1314:
1312:
1308:
1303:
1299:
1294:
1289:
1285:
1281:
1277:
1270:
1267:
1261:
1259:
1256:
1248:
1246:
1244:
1243:relationships
1240:
1236:
1232:
1231:impulsiveness
1228:
1224:
1220:
1216:
1212:
1209:
1205:
1202:
1197:
1191:
1189:
1185:
1179:
1177:
1173:
1164:
1162:
1160:
1156:
1150:
1148:
1144:
1140:
1139:renal failure
1136:
1135:mononucleosis
1132:
1127:
1123:
1119:
1110:
1108:
1105:
1101:
1097:
1092:
1086:
1084:
1080:
1075:
1071:
1067:
1063:
1059:
1055:
1051:
1047:
1043:
1039:
1036:
1032:
1031:interleukin-2
1028:
1024:
1020:
1016:
1012:
1008:
1000:
998:
996:
991:
987:
983:
979:
978:liver removed
974:
972:
969:
965:
961:
957:
953:
949:
945:
941:
937:
933:
929:
925:
921:
917:
913:
904:
897:
895:
893:
889:
885:
881:
876:
872:
868:
864:
860:
856:
855:cross-clamped
852:
848:
847:
842:
838:
834:
831:
827:
823:
818:
816:
812:
808:
804:
800:
796:
792:
791:cephalosporin
788:
784:
780:
776:
773:with several
772:
768:
764:
755:
753:
750:
745:
741:
737:
733:
729:
725:
721:
717:
711:
709:
705:
701:
697:
692:
683:
681:
679:
675:
671:
667:
663:
659:
655:
651:
646:
642:
638:
634:
630:
625:
623:
619:
615:
611:
607:
603:
599:
595:
591:
590:T-lymphocytes
587:
583:
582:immune system
578:
576:
572:
568:
565:quality, and
564:
560:
556:
552:
548:
544:
540:
536:
532:
528:
524:
520:
516:
509:
507:
505:
501:
498:
494:
490:
485:
481:
477:
473:
469:
465:
461:
457:
453:
449:
441:
439:
437:
433:
429:
426:, and severe
425:
421:
417:
412:
409:
408:Psychological
405:
401:
400:psychiatrists
397:
393:
389:
385:
381:
377:
373:
372:venous access
369:
365:
361:
353:
351:
349:
345:
340:
338:
334:
330:
325:
321:
317:
307:
300:
298:
296:
292:
288:
287:gastroschisis
284:
280:
276:
272:
268:
264:
260:
255:
251:
247:
243:
239:
235:
231:
227:
223:
219:
215:
211:
207:
203:
199:
195:
191:
183:
181:
179:
174:
170:
166:
161:
157:
149:
147:
145:
141:
137:
133:
132:liver disease
129:
125:
121:
117:
113:
109:
106:
102:
98:
94:
84:
75:
72:
70:
66:
62:
58:
53:
49:
43:
38:
33:
30:
19:
4282:Paracentesis
4096:Liver biopsy
3991:Enteroclysis
3976:Defecography
3831:Appendectomy
3797:
3299:Fikri Alican
3273:Fikri Alican
2854:
2708:
2666:cite journal
2639:
2635:
2625:
2590:
2586:
2576:
2541:
2537:
2489:
2486:EMBO Reports
2485:
2475:
2450:
2446:
2440:
2405:
2401:
2361:
2357:
2347:
2328:
2287:(5): 680–7.
2284:
2280:
2270:
2237:
2233:
2227:
2192:
2188:
2150:
2142:
2115:
2111:
2101:
2077:(8): 881–6.
2074:
2070:
2032:
1986:
1982:
1972:
1939:
1935:
1891:
1887:
1817:
1813:
1803:
1778:
1774:
1767:
1740:
1736:
1660:
1656:
1646:
1611:
1607:
1568:
1512:
1508:
1467:
1463:
1438:
1434:
1408:
1404:
1367:
1363:
1337:
1283:
1279:
1269:
1252:
1201:psychosocial
1192:
1180:
1168:
1151:
1114:
1100:carbohydrate
1087:
1070:surface area
1050:azathioprine
1004:
975:
971:feeding tube
909:
844:
819:
797:antibodies (
783:erythromycin
777:, including
767:immune cells
759:
744:demographics
712:
687:
626:
579:
513:
489:metastasized
445:
413:
357:
341:
312:
234:inflammation
198:electrolytes
187:
153:
100:
96:
92:
91:
29:
4272:Laparoscopy
4128:Gallbladder
4091:Hepatectomy
4021:Stool tests
3959:Proctoscopy
3954:Enteroscopy
3939:Colonoscopy
3823:Large bowel
3803:Jejunostomy
3763:Small bowel
3690:Hill repair
3673:Gastrostomy
3651:Billroth II
3641:Gastrectomy
3545:Sialography
3377:Bruce Reitz
3029:LifeSharers
3007:departments
2968:Organ trade
2810:Bone marrow
1364:BMC Nursing
1286:: 295–316.
1188:comorbidity
1143:calcineurin
1046:basiliximab
1038:antagonists
968:jejunostomy
920:anastomosis
912:scar tissue
875:vasculature
807:irradiation
803:alemtuzumab
775:antibiotics
672:(CMV), and
662:hepatitis B
637:coagulation
531:brain death
404:specialists
368:indications
354:Indications
333:dehydration
283:omphalocele
250:perforation
246:fistulation
206:homeostasis
173:ciclosporin
108:replacement
60:Other names
4409:Categories
4335:Laparotomy
4277:Omentopexy
4254:Peritoneum
3889:Anal canal
3668:Gastropexy
3646:Billroth I
2880:islet cell
2850:Heart–lung
2538:Pediatrics
1894:: 129–50.
1262:References
1219:appearance
1211:dependence
1204:disability
1118:epithelium
1104:amino acid
1042:daclizumab
964:gastronomy
956:endoscopic
936:infrarenal
888:transverse
795:lymphocyte
740:mixed race
652:should be
629:blood work
614:antibodies
555:blood flow
539:ventilator
493:thrombosis
392:dieticians
366:-approved
267:congenital
238:ulceration
230:physiology
214:infectious
178:tacrolimus
4132:bile duct
4057:Accessory
3935:Endoscopy
3846:Colostomy
3836:Colectomy
3793:Ileostomy
3723:Endoscopy
3656:Roux-en-Y
3527:Esophagus
3142:Countries
2855:Intestine
2715:eMedicine
1964:205115492
1474:eMedicine
1415:eMedicine
1344:eMedicine
1227:parenting
1176:morbidity
1096:discharge
1062:sirolimus
986:bile duct
952:ileostomy
942:into the
916:vena cava
851:dissected
835:into the
815:irrigated
714:younger.
639:profile,
551:excretory
547:endocrine
504:mesentery
482:, and/or
456:abdominal
380:pediatric
316:digestion
222:metabolic
218:traumatic
210:prognosis
190:nutrients
103:) is the
4203:Pancreas
3944:Anoscopy
3420:Eye bank
3323:Pancreas
3107:ORGANIZE
3068:Advocacy
2875:Pancreas
2696:Archived
2617:22778793
2568:20142294
2516:16819463
2467:10837558
2432:12062834
2424:25395218
2380:18282247
2311:11066140
2254:12239647
2219:15492558
2093:12884206
2005:16473063
1956:19726774
1908:18953814
1795:23932625
1759:21595748
1687:42811817
1679:16254497
1638:15798462
1539:20420650
1455:12671904
1396:15686591
1370:(1): 2.
1235:optimism
1208:narcotic
1196:autonomy
1184:etiology
1159:diarrhea
1141:because
1035:receptor
960:biopsies
940:portally
924:proximal
826:infusion
824:for the
822:cannulae
779:neomycin
732:Hispanic
691:perfused
618:antigens
500:ischemia
497:arterial
480:pancreas
476:duodenum
420:systemic
376:catheter
364:Medicaid
360:Medicare
337:catheter
295:volvulus
105:surgical
69:ICD-9-CM
3580:Stomach
2820:Corneal
2658:9825808
2608:3389745
2559:2854035
2507:1500832
2302:1421222
2262:9202249
2210:1356482
2134:9415566
1844:9306995
1835:1296456
1629:1357064
1302:8140977
1293:2954648
1215:anxiety
1033:(IL-2)
1019:lactate
1009:(ICU).
932:kidneys
884:stapled
880:pedicle
846:in situ
700:mucosal
658:viruses
635:(CBC),
602:protein
543:cardiac
515:Donated
502:of the
472:stomach
460:jejunum
430:and/or
428:cardiac
329:IV pump
226:anatomy
150:History
124:failure
116:chronic
110:of the
4297:Hernia
3861:Rectum
3230:Kidney
3187:People
3039:NOD-Lb
2912:Vagina
2907:Uterus
2902:Thymus
2897:Spleen
2860:Kidney
2656:
2615:
2605:
2566:
2556:
2514:
2504:
2465:
2430:
2422:
2378:
2335:
2309:
2299:
2260:
2252:
2217:
2207:
2159:
2132:
2091:
2039:
2003:
1962:
1954:
1906:
1842:
1832:
1793:
1757:
1685:
1677:
1636:
1626:
1576:
1537:
1453:
1394:
1387:549542
1384:
1300:
1290:
1223:stress
1153:10–10
995:spleen
982:clamps
928:distal
789:, and
749:median
730:, 16%
726:, 18%
720:ethnic
716:Adults
678:fungal
654:tested
643:, and
600:(MHC)
563:tissue
549:, and
468:enzyme
414:Other
293:, and
291:tumors
220:, and
196:, and
194:fluids
165:sepsis
160:Boston
4379:UKELD
4328:Other
4066:Liver
3355:Other
3339:Penis
3266:Liver
3194:Heart
2887:Penis
2865:Liver
2845:Heart
2815:Brain
2763:Types
2428:S2CID
2258:S2CID
1960:S2CID
1683:S2CID
1564:(PDF)
1505:(PDF)
1147:toxic
1079:flora
892:towel
867:cecum
837:aorta
736:Asian
734:, 1%
728:Black
724:White
650:serum
606:cells
484:colon
464:ileum
448:graft
167:, or
140:organ
120:acute
81:[
74:46.97
48:ileum
4374:PELD
4369:MELD
4176:MRCP
4150:ERCP
3292:Lung
3087:DKMS
2892:Skin
2870:Lung
2840:Head
2835:Hand
2830:Face
2805:Bone
2775:ABOi
2704:UNOS
2672:link
2654:PMID
2613:PMID
2564:PMID
2512:PMID
2463:PMID
2420:PMID
2376:PMID
2333:ISBN
2307:PMID
2250:PMID
2215:PMID
2157:ISBN
2130:PMID
2089:PMID
2037:ISBN
2001:PMID
1952:PMID
1904:PMID
1840:PMID
1791:PMID
1755:PMID
1675:PMID
1634:PMID
1574:ISBN
1535:PMID
1451:PMID
1392:PMID
1298:PMID
1206:and
1124:and
1102:and
1081:and
1060:and
1017:and
962:. A
926:and
869:and
839:and
765:and
664:and
569:and
519:body
462:and
362:and
265:and
228:and
134:and
118:and
114:for
4181:PTC
3523:SGs
2825:Eye
2713:at
2702:by
2644:doi
2603:PMC
2595:doi
2591:109
2554:PMC
2546:doi
2542:125
2502:PMC
2494:doi
2455:doi
2410:doi
2366:doi
2297:PMC
2289:doi
2285:232
2242:doi
2205:PMC
2197:doi
2193:240
2120:doi
2079:doi
1991:doi
1987:130
1944:doi
1940:361
1896:doi
1830:PMC
1822:doi
1783:doi
1745:doi
1665:doi
1624:PMC
1616:doi
1612:241
1527:hdl
1517:doi
1472:at
1443:doi
1439:124
1413:at
1382:PMC
1372:doi
1342:at
1288:PMC
1155:CFU
1091:gas
966:or
946:or
828:of
805:),
567:ABO
495:or
99:or
4411::
4349:/
4171:IV
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1052:,
1044:,
1015:pH
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781:,
708:kg
668:,
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545:,
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398:,
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289:,
281:,
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