Transplant Surgery

Oral and colonoscopic microbiota transplant achieved similar engraftment and symptom reduction in postoperative Crohn’s disease

In a single-blind pilot randomized trial of postoperative Crohn’s disease, encapsulated oral MTT and colonoscopic liquid MTT produced similar stool and neoterminal ileal donor engraftment at week 8. Both delivery routes yielded correlated stool and ileal engraftment and a pooled reduction in Harvey‑Bradshaw Index over 16 weeks. Donor engraftment levels did not correlate with clinical outcomes, so engraftment should not be used alone to predict benefit. Oral MTT was well tolerated, supporting further evaluation of capsules earlier in the postoperative course. 1

Combined medical and surgical therapy for hidradenitis suppurativa shows promise but evidence quality is low

A systematic review of eight studies (508 patients) found combination biologic plus surgery often improved response rates and pain versus biologic monotherapy. Reported benefits included higher HiSCR/IHS4‑55 response and better quality-of-life scores across studies. Safety appeared similar, with no consistent increase in postoperative complications or serious adverse events. Heterogeneity and low methodological quality limit confidence; prospective standardized studies are needed before changing practice. 2

Organ assessment and repair centers (ARCs) centralize perfusion to expand donor use and enable organ repair

ARCs use normothermic and hypothermic ex vivo perfusion to permit physiologic assessment and potential organ rehabilitation before transplant. The model aims to reduce discard rates, mitigate ischemia–reperfusion injury, and centralize technical and research expertise. Implementation faces major practical hurdles including capital cost, infrastructure, regulatory oversight, and complex logistics across transplant networks. 3