Abstract
Rejection is one of the most difficult complications to treat following intestinal transplantation. Both its occurrence and treatment options are associated with significant morbidity and mortality. Diagnosis is usually based on endoscopy and biopsy of the intestinal mucosa because clinical signs appear late in its course. Serum citrulline levels may be useful in suspecting the diagnosis. Mild rejection episodes can be treated with steroids, while moderate and severe rejections require use of antilymphocyte agents. Rejection that does not respond to therapy requires removal of the graft and possible re‐transplantation. Chronic rejection presents with malabsorption, dysmotility, and graft wall thickening, necessitating graft enterectomy.
