This may be needed for patients who have lost so much of their intestines that they cannot digest and absorb food sufficiently well to survive. It is commonest in babies who have suffered acute abdominal conditions such as VOLVULUS. Before the advent of small-bowel transplants, long-term intravenous feeding (total PARENTERAL NUTRITION or TPN) was the last option for patients with chronic intestinal failure. Small-bowel transplantation is currently reserved for patients unable to continue on long-term TPN. The main constraints to small-bowel transplantation are the intensity of rejection (necessitating high levels of immunosuppression), and the lack of donors who are the same size as the recipient (a particular problem for children).