TY - JOUR
T1 - The role of intestinal transplantation in the management of babies with extensive gut resections
AU - Kato, Tomoaki
AU - Mittal, Naveen
AU - Nishida, Seigo
AU - Levi, David
AU - Yamashiki, Noriyo
AU - Miller, Barbara
AU - Gonzalez, Monica
AU - Ruiz, Phillip
AU - Madariaga, Juan
AU - Nery, Jose
AU - Gelman, Barry
AU - Thompson, John
AU - Gyamfi, Anthony
AU - Tzakis, Andreas
PY - 2003/2/1
Y1 - 2003/2/1
N2 - Background/Purpose: Modern neonatal care, surgical treatment, and total parenteral nutrition (TPN) have improved survival rate for babies with extensive gut resections. The authors examined the role of intestinal transplantation in the treatment of these patients. Methods: The authors reviewed all pediatric intestinal transplants performed for short bowel syndrome at our center (70 transplants performed between Aug 1994 and Feb 2002). Factors affecting patient survival were analyzed. Results: Older patient age at the time of transplant was a significant factor favorably affecting patient survival (P = .031). Trends toward better survival rates were observed in those transplants performed more recently (P = .063), in those patients with greater body weight (P = .084), in those not hospitalized at the time of transplant (P = .14), and in those without concomitant liver failure (P = .12). Three-year survival rate for patients greater than age 2 years and without liver failure was 90%. However, 32% of our recipients underwent transplant at age less than one year, and most in this group (75%) had concomitant liver failure. Conclusions: For babies with irreversible intestinal failure, intestinal transplantation is a life-saving option. Results, which have recently improved, are best when transplantation compliments more conservative surgical treatments and TPN. However, there is a subset of patients who have liver disease early requiring urgent transplant.
AB - Background/Purpose: Modern neonatal care, surgical treatment, and total parenteral nutrition (TPN) have improved survival rate for babies with extensive gut resections. The authors examined the role of intestinal transplantation in the treatment of these patients. Methods: The authors reviewed all pediatric intestinal transplants performed for short bowel syndrome at our center (70 transplants performed between Aug 1994 and Feb 2002). Factors affecting patient survival were analyzed. Results: Older patient age at the time of transplant was a significant factor favorably affecting patient survival (P = .031). Trends toward better survival rates were observed in those transplants performed more recently (P = .063), in those patients with greater body weight (P = .084), in those not hospitalized at the time of transplant (P = .14), and in those without concomitant liver failure (P = .12). Three-year survival rate for patients greater than age 2 years and without liver failure was 90%. However, 32% of our recipients underwent transplant at age less than one year, and most in this group (75%) had concomitant liver failure. Conclusions: For babies with irreversible intestinal failure, intestinal transplantation is a life-saving option. Results, which have recently improved, are best when transplantation compliments more conservative surgical treatments and TPN. However, there is a subset of patients who have liver disease early requiring urgent transplant.
KW - Intestinal transplantation
KW - Short bowel syndrome
UR - http://www.scopus.com/inward/record.url?scp=0037310247&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037310247&partnerID=8YFLogxK
U2 - 10.1053/jpsu.2003.50033
DO - 10.1053/jpsu.2003.50033
M3 - Article
C2 - 12596093
AN - SCOPUS:0037310247
SN - 0022-3468
VL - 38
SP - 145
EP - 149
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 2
ER -