Since the development of new immunosuppressive agents, as FK506, the results of small bowel transplantation have greatly improved. The patient survival at one year has increased from 25% during the cyclosporin era to 65% in 1995 and the graft survival from 19% to 57% respectively. Clearly, the postoperative complications are still frequent and severe and do not allow a wide generalisation of this method. However, total parental nutrition is not an appropriate solution for the long term management of patients with terminal intestinal insufficiency. In Switzerland, these patients survive for several years and finally die of problems that small bowel transplantation could already successfully overpass.