Darmtransplantatie en darmischemie: strategieën om de toegang tot en de resultaten van darmtransplantatie en darmischemie te verbeteren

Intestinal transplantation (ITx) represents the only life-saving therapy for patients with intestinal failure and parenteral nutrition related complications. ITx is rarely performed, only 4000 worldwide up to now, due to a limited long-term survival, especially in comparison to other solid-organ transplantation. This is attributed to several medical, surgical, and immunological challenges. Ischemia reperfusion injury (IRI) is inevitably correlated with solid-organ transplantation and this is detrimental in ITx. In the intestine, IRI leads to an increased permeability, bacterial translocation and inflammation which compromises the clinical status of the patient and the acceptance of the intestinal graft. Outside the field of ITx, intestinal IRI is a very frequent pathology with a high mortality. The latter is due to late diagnosis by lack of biomarkers and limited treatment options. This thesis will focus on modulation of intestinal IRI and ITx in clinical studies and rodent experiments.