The team determined the long-term results of intestinal transplantation in children with pseudo-obstruction, particularly when stomach and colon were not part of the allograft.
Their findings have been recorded in this month's Journal of Pediatric Surgery.
A case-record review of all children who underwent transplantation, at a single center, for a primary diagnosis of pseudo-obstruction was conducted. Supplementary information was obtained from outpatient charts, computerized database, and telephone survey of parents.
Six small bowel and 3 liver-small bowel transplants were carried out in 8 patients between 1993 and 1999.
Outcome of the 8 patients after transplantation:
- 5 were receiving full enteral feeding at home
- 4 had ileostomies closed
- 3 had normal bowel movements
- 2 had died
- 1 had lost two grafts
|J Pediatr Surg|
The median follow-up period was 40 months and median age at transplantation was 2.7 years.
The researchers found that median graft survival in this series was 15 months.
Two children died 5 and 368 days after transplant and 2 graft losses occurred in one patient. Two of the children had lymphoproliferative disease; both were still alive with functioning grafts at the time of the study.
The team reported that five survivors with functioning grafts were receiving full enteral feedings at home. Four of these 5 have had ileostomies closed, and 3 had normal bowel movements.
Researcher Kishore Iyer concluded on behalf of the group that, "Intestinal transplantation without stomach or colon provides children with chronic intestinal pseudo-obstruction with a good quality of life.
"The underlying disease poses special challenges in management."