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Association of Crohn's disease-associated NOD2 variants with intestinal failure requiring small bowel transplantation and clinical outcomes
  1. M Janse1,2,
  2. R K Weersma1,
  3. D L Sudan3,
  4. E A M Festen1,2,
  5. C Wijmenga2,
  6. G Dijkstra1,
  7. D Mercer4
  1. 1Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
  2. 2Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
  3. 3Department of Abdominal Transplant Surgery, Duke University Medical Center, Durham, USA
  4. 4Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Dr RK Weersma, Department of Gastroenterology and Hepatology, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands; R.K.Weersma{at}

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In the past decade intestinal transplantation has evolved to a viable option in the treatment of short bowel syndrome, especially for patients who have developed life-threatening complications attributable to their intestinal failure and/or long-term total parental nutrition therapy.1 Technical improvements, novel immunosuppressive agents and increased clinical experience have contributed to an improvement in intestineal transplant graft and patient survival. One-year graft and patient survival are nowadays both estimated at 80%.2 3

Despite these recent advances, rejection resulting in failure of the graft still remains a problem causing significant patient morbidity and mortality. Identifying involved pathogenetic mechanisms might make it possible to predict or eventually prevent intestinal graft failure or rejection.

We would like to respond to the interesting study by Fishbein et al recently published in this journal.4 The authors point out the …

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    Thomas M Fishbein Michael Zasloff