The role of transplantation in the management of intestinal failure continues to evolve. Since the development of parenteral nutrition in the late 1960s, permanent intestinal failure has been medically managed with visceral transplantation, reserved for those who develop life-threatening complications. A multidisciplinary approach to intestinal care has led to the emergence of intestinal rehabilitation programs that have successfully achieved nutritional autonomy for many individuals through the promotion of adaptation. Whereas the short-term results of visceral transplantation have improved dramatically to the level of other solid organs, durable long-term graft survival has been elusive. This review covers intestinal failure, epidemiology, intestinal and multivisceral transplantation, and the future of intestinal and multivisceral transplantation. Figures show the embryonic origin of the multivisceral allograft, en bloc retrieval of the intestinal allograft, preparation for engraftment, vascularization of the isolated intestinal allograft, enteric reconstruction of the intestinal allograft, the liver-intestine allograft, preparation for liver-intestine engraftment, the modified m
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