Introduction: Intestinal Failure (IF) is defined as “the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes to maintain health and/or growth”. The primary pathophysiological mechanism in adults (ad) patients (pts) is due to short gut syndrome (SBS). The probability of weaning off parenteral nutrition (PN) has been reported to be below 50%, considering this possibility cannot be achieve after 2 years. Those pts would benefit from an adequate evaluation and support at a specialized IF unit. We aim to present the long term results after Autologous Gastrointestinal Reconstruction (AGIR) in a cohort of pts with type III IF (IF III) and its correlation to post surgical anatomy and post-surgical medical support. Methods: a retrospective analysis of a prospective database of ad pts with IF III, who received AGIR, from 3/2006 to 12/2016. Age, sex, primary diagnosis, pre and post-surgical PN support, post-surgical intestinal length (a:≤50cm; b: 51 to 99cm and c:≥100cm, type of anatomy 1: terminal jejunostomy, 2: jejuno-colonic anastomosis, 3: jejuno-ileo-colonic anastomosis), presence of ileocecal valve (ICV); PN reduction > 2 days per week, freedom from PN and patient survival were analyzed using SPSS v.20. Results: A total of 310 pts with IF, 208 were ad 173 (83.17%) had IF III and 133 (77.45%) were secondary to SBS. AGIR was offered to 71 pts; 58.57% were male, mean age 52 ± 13 yrs. Diagnoses were: post-surgical IF 55.71%; ischemia 22.85%; post-bariatric surgery 5.71%; trauma 4.28%, other 11.43%. The whole colon and ICV was preserved in 38 pts (54.28%). Pre and post surgical PN time, post-surgical intestinal length and type of post-surgical anatomy, reduction and freedom from PN are shown in table 1. Overall freedom from PN was 83% (Fig1). Long-term survival was over 80% at 5 yrs, no difference was seen between groups; all deaths occur in oncological pts.FigureFigureConclusions: AGIR in the context of an IF program offers an excellent therapeutic option for to recover intestinal sufficiency. The intestinal length and type of anatomy remained as valuable variables to predict post-surgical outcomes; in patients with ultra short gut; but the availability of GLP-2, opens a new alternative to achieved post-surgical rehabilitation independently of the anatomical variables, reducing the time of PN or sufficiency. Larger series are needed to prove these initial results. References: 1. Iyer KR. Surgical Management of Short Bowel Syndrome. J Parenter Enteral Nutr. 2014; 38: 53–59. 2. Jeppesen PB. Pharmacologic Options for Intestinal Rehabilitation in Patients with Short Bowel Syndrome. J Parenter Enteral Nutr. 2014; 38: 45–52. 3. Javid PJ. Serial transverse enteroplasty is associated with successful short-term outcomes in infants with short bowel syndrome. J Pediatr Surg. 2005; 40(6):1019–1023. 4. Yannam GR. Intestinal lengthening in adult patients with short bowel syndrome. J Gastrointest Surg. 2010; 14: 1931–1936. 5. Moon J. Intestinal rehabilitation and transplantation for intestinal failure. Mt Sinai J Med. 2012; 79 :256–66. 6. Jeppesen PB. Teduglutide Reduces Need for Parenteral Support Among Patients with Short Bowel Syndrome with Intestinal Failure. Gastroenterology 2012;143:1473–1481. 7. Schwartz LK. Long-Term Teduglutide for the Treatment of Patients with Intestinal Failure Associated with Short Bowel Syndrome. Clin Transl Gastroenterol. 2016; 7:142.