In contrast to the continuously increasing success in kidney, liver, heart, and pancreas transplantation, small-bowel transplantation has not shown simi­ larly impressive progress until recently. The few clinical attempts at small-intestinal transplantation in the late 1960s and early 1970s were unsuccessful. In spite of these initial failures, a few groups of surgeons continued to investigate the problems of small-bowel transplantation from the technical, functional, and immunologic point of view. Now, about 15 years later, conditions have changed. Total parenteral nutrition has made tremendous progress, thus maintaining patients with short-bowel syndrome who are potential recipients of small-bowel grafts in an acceptable physical condition. Immunologists and clinicians have furt­ hermore been able to expand our knowledge of basic immunologic reactions induced by transplanted organs. In addition, within the last 8 years, new immunosuppressive drugs and regimens have been introduced which have proved to be extremely effective. Taking all these aspects into account, we regarded it as an extremely worthwhile and effective undertaking to invite scientists from all over the world who are working in the field of small-bowel transplantation to participate in a symposium on this topic. This meeting, the first to deal exclusively with small-bowel transplantation, was held in Kiel, West Ger­ many, in October 1985. Its aims were twofold: 1. ) To'stimulate direct communication between basic scientists and clini­ cians 2.

Session 1Evaluation of Experimental Models of Small-Bowel Transplantation in the Rat.- Microsurgical Techniques of Heterotopic and Orthotopic Small-Bowel Transplantation in the Rat.- Small-Bowel Transplantation in the Rat: Graft Survival with Heterotopic vs Orthotopic Position.- Recent Results of Small-Bowel Transplantation in the Rat Model.- Metabolic Effects of Systemic Venous Drainage in Small-Bowel Transplantation.- Session 1: Summary.- Session 2 Experimental Models in Large Animals.- Small-Bowel Transplantation in the Pig.- Lymphatic Regeneration Following Intestinal Transplantation in the Pig.- Serum Lactic Dehydrogenase in Small-Bowel Transplantation in the Pig.- In Vitro and In Vivo Studies of the Mucosal Immune Barrier After Long-Term Small-Bowel Allotransplantation in Pigs Using Cyclosporine.- Orthotopic Segmental Small-Intestinal Transplantation in the Dog.- Duodenal Histology During Rejection of Whole-Organ Pancreaticoduodenal Allografts in the Pig.- Segmental Small-Bowel Replacement by Gastric Tube in the Pig.- Session 2: Summary.- Session 3 Intestinal Absorption and Adaptation.- Absorption and Graft Function After Small-Intestinal Transplantation.- Intestinal Preservation of Small-Bowel Grafts by Vascular Washout and Cold Storage.- Glucose Absorption After Heterotopic Small-Bowel Transplantation.- Absorption Studies After Orthotopic Small-Bowel Transplantation.- Functional Adaptation of the Small-Intestinal Mucosa After Experimental Small-Bowel Transplantation: A Quantitative Histochemical Study.- Patterns of Gastrointestinal Hormone Distribution After Small-Bowel Transplantation.- Session 3: Summary.- Session 4 Immunology.- Early Intestinal Lesions of Graft-vs-Host Reaction and Allograft Rejection in Rodents, Identified by Quantitative Histological Techniques.- Mucosal Mast Cells in Experimental Graft-vs-Host Reaction.- Clinicopathologic Differentiation of Rejection and Graft-vs-Host Disease Following Small-Bowel Transplantation.- Graft-vs-Host Reaction After Small-Bowel Transplantation Compared with Graft-vs-Host Reaction After Bone Marrow Transplantation.- Rejection in Heterotopic Small-Bowel Transplantation.- Rejection in Orthotopic Small-Bowel Transplantation and Immunosuppression by Cyclosporine A: Evidence for Development of Tolerance Mechanisms.- Course of Rejection in Pancreaticoduodenal Allografts in the Rat.- Prevention of Graft-vs-Host Disease Using In Vitro Irradiation of Small-Bowel Grafts.- Graft Acceptance: Modification of Immunogenicity of the Donor or the Donor Organ with or without Host Immunosuppression.- Session 4: Summary.- Session 5 Immunosuppression.- Long-Term Survival of Orthotopic Small-Bowel Allografts Using Cyclosporin A.- Influence of Cyclosporine A on Small-Bowel Grafts and Subsequent in Vitro Immune Reactions.- Different Modes of Cyclosporine A Administration in Experimental Small-Bowel Transplantation.- Session 5: Summary.- Session 6 Surgical Techniques in Animals and Man.- Intestinal Transplantation: Surgical Techniques in Animals and Man.- Stoma or No Stoma in Intestinal Transplantation.- Small-Bowel Allotransplantation in Pigs Using Cyclosporine A: Technique and Results.- Session 6: Summary.- Session 7 Clinical Considerations.- Physical and Psychological Preparedness of Short-Bowel Patients for Small-Bowel Transplantation.- Procurement of Intestinal Allografts from Living Related and from Cadaver Donors.- Session 7: Summary.- Session 8 Nutritional Support Prior to and During Intestinal Transplantation.- Experience in Home Parenteral Nutrition and Indications for Small-Bowel Transplantation.- Enteral and Parenteral Feeding of Patients with Short-Bowel Syndrome.- Methods of Perioperative Nutritional Support and Their Possible Application in Small-Bowel Transplantation.- Session 8: Summary.- Session 9 Immunological and Clinical Monitoring After Transplantation.- Monitoring of Small-Bowel Grafts by Mucosal Suction Biopsies.- Monitoring of Small-Bowel Allograft Rejection: Maltose Absorption.- Porcine Ileal Peptide: A Potential Marker for Rejection of Small-Intestine Allografts.- Session 9: Summary.- Session 10 Indications for Small-Bowel Grafting in Children and Adults.- Potential Recipients for Small-Bowel Transplantation in the United States and the United Kingdom.- Indications for Small-Bowel Transplantation in Children.- Session 10: Summary.