Pediatric intestinal transplant serves as the only definitive treatment for children with irreversible intestinal failure. Successful intestinal transplant hinges upon appropriate management of immunosuppression. The indications for intestinal transplant have changed over time. Immunosuppression regimens can be divided into induction and maintenance phases along with treatment of acute rejection. Intestinal transplant induction now often includes antithymocyte globulin or basiliximab in addition to corticosteroids. Maintenance regimens continue to be dominated by tacrolimus, with additional agents used to either decrease goal tacrolimus levels to limit toxicity or as an adjunct in sensitized patients. Careful monitoring can help to limit serious complications, such as rejection, infection, and malignancy. Future work will aim to decrease variation in practice and identify methods to determine optimal immunosuppression for a particular patient. Furthermore, there is a need for non-invasive monitoring of the intestinal graft and functional assessments of immunosuppression.

小儿肠移植是治疗不可逆肠功能衰竭儿童的唯一确定方法。成功的肠道移植取决于对免疫抑制的适当管理。随着时间的推移，肠移植的适应症发生了变化。免疫抑制方案可分为诱导期和维持期以及急性排斥反应的治疗。除皮质类固醇外，现在肠移植诱导通常包括抗胸腺细胞球蛋白或巴利昔单抗。维持方案继续以他克莫司为主，其他药物用于降低他克莫司的目标水平以限制毒性或作为敏感患者的辅助药物。仔细监测可以帮助限制严重的并发症，例如排斥、感染和恶性肿瘤。未来的工作将旨在减少实践中的变化，并确定确定特定患者最佳免疫抑制的方法。此外，需要对肠移植物进行非侵入性监测和免疫抑制的功能评估。