Very young pediatric patients awaiting intestinal transplantation have a high mortality rate due to long waiting times, scarcity of appropriate size donor organs, and mortality due to sepsis and liver failure.
Dr Sameera Mian and colleagues investigated specific risk factors impacting survival to intestinal transplantation.
|Intestinal atresia was the most common diagnosis in the deceased group|
A 4-year institutional retrospective study compared children who received grafts by age 18 months with children 18 months or younger who died while on the waiting list.
The team reported that 12 children comprised the transplanted group.
The children had the underlying diagnoses of necrotizing enterocolitis, gastroschisis, Hirschsprung's disease, and omphalocele.
The researchers reported that 10 children comprised the deceased group.
These children had underlying intestinal atresia, necrotizing enterocolitis, gastroschisis, and midgut volvulus.
Multiple risk factors were assessed in these groups.
The researchers found no differences in residual small bowel length, presence of the colon, number of line infections, or number of central lines.
The average body weight of the transplanted group trended higher, whereas the deceased group had more impairment of hepatic function.
The research team found intestinal atresia was the most common diagnosis in the deceased group, while none of the transplanted group carried this diagnosis.
Ileocecal valve was retained in 80% of the deceased group, and in none of the transplanted group.
Dr Mian‘s team commented, "In children younger than 18 months, risk factors affecting survival to intestinal transplantation include small body size and advanced liver disease.
"A primary diagnosis of intestinal atresia and the presence of the ileocecal valve may confer additional risk to these very young children."