The lack of controlled interventional studies limits the ability to assess optimal management of intestine transplant recipients. This report aims to examine factors that probably impact on the quality of patient care in the setting of intestine transplantation. The specific practice in the most experienced intestine transplant programs in the United States was surveyed with regard to immunosuppressive regimens, treatment of acute allograft rejection, feeding, and viral surveillance and treatment. The most striking finding was in the level of agreement between the centers, particularly with regard to use of tacrolimus for maintenance immunosuppression, methylprednisone boluses for treatment of acute rejection, early postoperative enteral feeding, and ganciclovir prophylaxis.