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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."
Preclinical experimental transplantation research that is based on
microsurgical models in rats fulfills two indispensable conditions
for modern organ transplanta tion research: Almost all organ grafts
can be performed on the rat with an amount of technical effort that
is still justifiable. Thus transplantation models that are
analogous to human organ transplantation can be developed, tested,
and evaluated. This fulfills a necessary condition from the
standpoint of surgery. With the species rat, we have a great
variety of genetically different inbred strains. From the
immunological point of view this is an indispensable prerequisite
for the investigation of preclinical transplantation models that
can be expected to produce controllable, reproducible results. In
vivo experimental results can be supplemented by and correlated to
in vitro tests. Lately these experimental results are being greatly
expanded and more precisely defined by the application of
immunohistological methods that have been established recently in
Kiel. In this book we hope to present a cross section of the
microsurgical models in use today and of current immunological and
immunohistological models. Furthermore, we wish to record the
present state of microsurgical organ transplantation research and
to show its relationship to the current state and development of
clinical organ transplantation. A special aspect of our Kiel
research group is the long-term, well-functioning,
interdisciplinary cooperation between surgery, immunology, and
pathology. Through this cooperation we attempt to provide an
atmosphere in which theoretical and practical viewpoints can
mutually influence each other."
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