Intestinal transplantation (ITx) is the only definitive therapy for irreversible intestinal failure. Due to low patient and graft outcome as well as limited historical data on short-term and long-term graft survival in patients undergoing this procedure, ITx has been seen as complementary but not competitive to HOME PARENTERAL NUTRITION (HPN). The reason for improved outcome of ITx, particularly after 1998, is the progress in immunosuppression therapies. The use of interleukin-α2 receptor (IL2R) monoclonal antibodies (mAbs), and, lately, depleting antibodies, has lead to 1-year intestinal transplant graft survival rates as high as 85% and an impressive reduction of rejection rates, which still represent one of the main risks for graft failure.
In patients with intestinal failure, current short-term success rates for therapy with intestinal transplantation match those of HPN. Provided that long-term outcome confirms these data, intestinal transplantation might be considered as a primary treatment option in the future.

Intestinal transplantation is an international established therapy for patients with short bowel syndrome, that suffer from complications of total parental nutrition like liver-cirrhosis, portal hypertention and recurrend catheter infections.
Since the beginning of the 90th intestinal transplantation has become clinically practible due to the implementation of Tacrolimus. However, the long-term outcome following transplantation remains one of the major problems. While acute rejection episodes can be treated sufficiently meanwhile, like in transplantation of other solid organs, chronic graft failure remains a major problem. Although the one-year survival rate after intestinal transplantation had increased significantly in the last years, a high rate of graft loss is persisting in the time post transplantation. New therapeutical concepts like the application of TNF-α inhibitors are necessary to handle chronic graft injury.

Today liver transplantation (LTx) often represents the only curative therapy for patients with end-stage liver deseases in the terminal stadium, e.g. acute and chronic liver collapse and specific metabolic dysfunctions of the liver. In experienced transplant centers further development and clinical experience in the field of liver surgery and immunosuppression therapy resulted in the establishment of liver transplantation as a standard method, which is associated with a low risk of morbidity and mortality. Although the number of potential liver-allograft recipients is growing, the number of transplantations remains static with a declining rate of cadaver donors. Despite increasing use of so called marginal organs the number of realised explantations is decreasing, while the mortality in the waiting list is growing. The living-donor liver transplantation may compensate the decreasing number of liver transplantations after postmortal organ donation.