Small Bowel and Liver/small Bowel Transplantation in Children

Overview

Journal Semin Pediatr Surg

Specialty Pediatrics

Date 1993 Nov 1

PMID 8062049

Citations 8

Authors

J Reyes

A G Tzakis

S Todo

B Nour

T E Starzl

Affiliations

Soon will be listed here.

Abstract

A clinical trial of intestinal transplantation was initiated at the University of Pittsburgh in May 1990. Eleven children received either a combined liver/small bowel graft (n = 8) or an isolated small bowel graft (n = 3). Induction as well as maintenance immunosuppression was with FK-506 and steroids. Four patients were male, and seven were female; the age range was 6 months to 10.2 years. There were 3 deaths (all in recipients of the combined liver/small bowel graft), which were attributed to graft-versus-host disease (n = 1), posttransplant lymphoproliferative disease (n = 1), and biliary leak (n = 1). Transplantation of the intestine has evolved into a feasible operation, with an overall patient and graft survival rate of 73%. These survivors are free of total parenteral nutrition, and the majority are home. These encouraging results justify further clinical trials.

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References

Lillehei R, Idezuki Y, Feemster J, Dietzman R, KELLY W, Merkel F . Transplantation of stomach, intestine, and pancreas: experimental and clinical observations. Surgery. 1967; 62(4):721-41. View

Goulet O, Revillon Y, Jan D, Brousse N, De Potter S, Cerf-Bensussan N . Small-bowel transplantation in children. Transplant Proc. 1990; 22(6):2499-500. View

Grant D . Intestinal transplantation: current status. Transplant Proc. 1989; 21(1 Pt 3):2869-71. View

Grosfeld J, Rescorla F, West K . Short bowel syndrome in infancy and childhood. Analysis of survival in 60 patients. Am J Surg. 1986; 151(1):41-6. DOI: 10.1016/0002-9610(86)90009-7. View

Howard L, Heaphey L, Fleming C, Lininger L, Steiger E . Four years of North American registry home parenteral nutrition outcome data and their implications for patient management. JPEN J Parenter Enteral Nutr. 1991; 15(4):384-93. DOI: 10.1177/0148607191015004384. View

Reyes J, Tzakis A, Todo S, Nour B, Casavilla A, Abu-Elmagd K . Nutritional management of intestinal transplant recipients. Transplant Proc. 1993; 25(1 Pt 2):1200-1. PMC: 2963992. View

Casavilla A, Selby R, Abu-Elmagd K, Tzakis A, Todo S, Reyes J . Logistics and technique for combined hepatic-intestinal retrieval. Ann Surg. 1992; 216(5):605-9. PMC: 1242681. DOI: 10.1097/00000658-199211000-00014. View

Abu-Elmagd K, Tzakis A, Todo S, Reyes J, Fung J, Nakamura K . Monitoring and treatment of intestinal allograft rejection in humans. Transplant Proc. 1993; 25(1 Pt 2):1202-3. PMC: 2965470. View

Steiger E, Srp F . Morbidity and mortality related to home parenteral nutrition in patients with gut failure. Am J Surg. 1983; 145(1):102-5. DOI: 10.1016/0002-9610(83)90174-5. View

10.

Wilmore D . Factors correlating with a successful outcome following extensive intestinal resection in newborn infants. J Pediatr. 1972; 80(1):88-95. DOI: 10.1016/s0022-3476(72)80459-1. View

11.

Todo S, Tzakis A, Abu-Elmagd K, Reyes J, Nakamura K, Casavilla A . Intestinal transplantation in composite visceral grafts or alone. Ann Surg. 1992; 216(3):223-33; discussion 233-4. PMC: 1242598. DOI: 10.1097/00000658-199209000-00002. View

12.

Venkataramanan R, Jain A, Warty V, Abu-Elmagd K, Furakawa H, Imventarza O . Pharmacokinetics of FK 506 following oral administration: a comparison of FK 506 and cyclosporine. Transplant Proc. 1991; 23(1 Pt 2):931-3. PMC: 3032435. View

13.

Jain A, Fung J, Todo S, Alessiani M, Takaya S, Abu-Elmagd K . Incidence and treatment of rejection episodes in primary orthotopic liver transplantation under FK 506. Transplant Proc. 1991; 23(1 Pt 2):928-30. PMC: 2967371. View

14.

Starzl T, Hakala T, Shaw Jr B, Hardesty R, Rosenthal T, Griffith B . A flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet. 1984; 158(3):223-30. PMC: 2728063. View

15.

Tzakis A, Todo S, Reyes J, Nour B, Fung J, Starzl T . Piggyback orthotopic intestinal transplantation. Surg Gynecol Obstet. 1993; 176(3):297-8. PMC: 2639715. View

16.

Starzl T, Kaupp Jr H . MASS HOMOTRANSPLANTATION OF ABDOMINAL ORGANS IN DOGS. Surg Forum. 2011; 11:28-30. PMC: 3091286. View

17.

Tzakis A, Reyes J, Nour B, Marino I, Todo S, Starzl T . Temporary end to side portacaval shunt in orthotopic hepatic transplantation in humans. Surg Gynecol Obstet. 1993; 176(2):180-2. PMC: 2729161. View

18.

Reyes J, Abu-Elmagd K, Tzakis A, Nour B, Casavilla A, Kusne S . Infectious complications after human small bowel transplantation. Transplant Proc. 1992; 24(3):1249-50. PMC: 2957090. View

19.

Shaw Jr B, Martin D, Marquez J, Kang Y, Bugbee Jr A, Iwatsuki S . Venous bypass in clinical liver transplantation. Ann Surg. 1984; 200(4):524-34. PMC: 1250523. DOI: 10.1097/00000658-198410000-00013. View

20.

Takaya S, Iwaki Y, Starzl T . Liver transplantation in positive cytotoxic crossmatch cases using FK506, high-dose steroids, and prostaglandin E1. Transplantation. 1992; 54(5):927-9. PMC: 2965439. DOI: 10.1097/00007890-199211000-00031. View