scholarly journals P-75: Living Donor Intestinal Transplantation: A Valuable Strategy to Overcome the Shortage of Pediatric Small Bowel Donors

2021 ◽  
Vol 105 (7S) ◽  
pp. S88-S88
Author(s):  
Vincenzi R ◽  
Person N ◽  
Fonseca E ◽  
Longo R ◽  
Roda K ◽  
...  
Keyword(s):  
Small Bowel ◽  
Living Donor ◽  
Intestinal Transplantation ◽  
P 75

Pattern of growth after pediatric living-donor small bowel transplantation

2006 ◽  
Vol 10 (6) ◽  
pp. 701-706 ◽  
Author(s):  
Marian Porubsky ◽  
Giuliano Testa ◽  
Eunice John ◽  
Mark Holterman ◽  
Marc Tsou ◽  
...  
Keyword(s):  
Small Bowel ◽  
Living Donor ◽  
Small Bowel Transplantation

Preliminary Experience With Intestinal Transplantation in Infants and Children

PEDIATRICS ◽  
1996 ◽  
Vol 97 (4) ◽  
pp. 443-448
Author(s):  
Alan N. Langnas ◽  
B. W. Shaw ◽  
Dean L. Antonson ◽  
Stuart S. Kaufman ◽  
David R. Mack ◽  
...  
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Gastrointestinal Disease ◽  
Intestinal Transplantation ◽  
Infants And Children ◽  
Short Bowel ◽  
In Infants And Children

Objective. This report discusses the preliminary experience with intestinal transplantation in children at the University of Nebraska Medical Center. Patients. During the past 4 years, 16 intestinal transplants have been performed in infants and children. Thirteen have been combined liver and bowel transplants, and the remainder were isolated intestinal transplants. Nearly half of the patients were younger than 1 year of age at the time of surgery, and the vast majority were younger than 5 years of age. All but one had short bowel syndrome. Results. The 1-year actuarial patient and graft survival rates for recipients of liver and small bowel transplants were 76% and 61%, respectively. Eight of 13 patients who received liver and small bowel transplants remain alive at the time of this writing, with a mean length of follow-up of 263 (range, 7 to 1223) days. Six patients are currently free of total parenteral nutrition. All three patients receiving isolated intestinal transplants are alive and free of parenteral nutrition. The mean length of follow-up is 384 (range, 330 to 450) days. Major complications have included severe infections and rejection. Lymphoproliferative disease, graft-versus-host disease, and chylous ascites have not been major problems. Conclusions. Although intestinal transplantation is in its infancy, these preliminary results suggest combined liver and bowel transplants and isolated intestinal transplantation may be viable options for some patients with intestinal failure caused by short bowel syndrome or other gastrointestinal disease in whom long-term total parenteral nutrition is not an attractive option.

Effects of massive bowel resection

2020 ◽  
pp. 2911-2916
Author(s):  
Stephen J. Middleton ◽  
Simon M. Gabe ◽  
Raymond J. Playford
Keyword(s):  
Small Bowel ◽  
Protein Energy Malnutrition ◽  
Intestinal Resection ◽  
Intestinal Transplantation ◽  
Renal Stones ◽  
Electrolyte Solutions ◽  
Venous Access ◽  
Vitamin B ◽  
Protein Energy

Major vascular events involving the superior mesenteric artery and small-bowel volvulus are the commonest reasons for adults to require massive intestinal resection. The ability of the residual bowel to adapt after resection varies greatly between patients, but common postoperative problems include sepsis, diarrhoea (or high-output stoma losses), fluid and electrolyte imbalance, malnourishment (protein–energy malnutrition, mineral and vitamin deficiencies), gallstones, renal stones, and psychological illness. Where appropriate, oral nutrition, initially consisting of low-volume polymeric feeds administered by nasogastric or enteral tube, should be started within the first few days of surgery. Small-volume, frequent, solid or semisolid meals with low long-chain triglycerides and (when colon is in continuity) oxalate content should be introduced subsequently, and isotonic electrolyte solutions given as required. Oral multivitamin and mineral supplements are usually needed, and vitamin B12 injections may be required. There should be regular long-term monitoring of fat-soluble vitamins (A and D), vitamin B12, folate, magnesium, zinc, and bone status. Long-term intravenous nutrition is sometimes needed. Growth factor administration, especially glucagon-like peptide-2 analogues, may stimulate bowel adaptation. Small-bowel lengthening may be considered for patients with dilated bowel close to the length required. Those who are dependent on peripheral nutrition and develop complications such as loss of venous access or liver disease should be considered for intestinal transplantation.

Combined Living Donor Liver/Small Bowel Transplantation

2005 ◽  
Vol 79 (10) ◽  
pp. 1401-1404 ◽  
Author(s):  
Giuliano Testa ◽  
Mark Holterman ◽  
Eunice John ◽  
Susan Kecskes ◽  
Herand Abcarian ◽  
...  
Keyword(s):  
Small Bowel ◽  
Living Donor ◽  
Small Bowel Transplantation ◽  
Donor Liver

scholarly journals Small bowel transplantation in outbred rats

2011 ◽  
Vol 26 (6) ◽  
pp. 496-502 ◽  
Author(s):  
Daniel Reis Waisberg ◽  
André Dong Wong Lee ◽  
Rafael Miyashiro Nunes dos Santos ◽  
Eduardo Kenji Mory ◽  
Anderson Lino Costa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Clinical Course ◽  
Small Bowel Transplantation ◽  
Intestinal Transplantation ◽  
Technical Failure ◽  
Histopathological Changes ◽  
Clinical Evolution ◽  
Intestine Transplantation ◽  
Small Intestine Transplantation ◽  
Cellular Rejection

PURPOSE: To investigate the clinical evolution of orthotopic small bowel transplantation in outbred rats. METHODS: Seventy-two outbred Wistar rats weighting from 250 to 300g were used as donor and recipient in 36 consecutives ortothopic small intestine transplantation without immunosuppression. The graft was transplanted into the recipient using end-to-side aortic and portacaval microvascular anastomosis. Procedure duration, animal clinical course and survival were evaluated. Survival shorter than four days was considered technical failure. Recipients were sacrificed with signs of severe graft rejection or survival longer than 120 days. Necropsies were performed in all recipients to access histopathological changes in the graft. RESULTS: Median time for the procedure was 107 minutes. Six recipients (16.7%) presented technical failure. Twenty-seven recipients were sacrificed due to rejection, being nineteen (52.7%) between 7th and 15th postoperative day and eight (22.2%) between 34th and 47th postoperative day. Graft histology confirmed severe acute cellular rejection in those recipients. Uneventful evolution and survival longer than 120 days without rejection were observed in three recipients (8.3%). CONCLUSION: Intestinal transplantation in outbred rats without immunosuppressant regiment accomplishes variable clinical evolution.

Case Report of Isolated Intestinal Transplantation from a Living Donor in Crossmatch Positive Recipient after Pre-transplant Immunomodulation

2017 ◽  
Vol 101 ◽  
pp. S106
Author(s):  
Hye Kyung Chang ◽  
Shinn Young Kim ◽  
Mi-Hyeong Kim ◽  
Jeong Kye Hwang ◽  
Ji-Il Kim ◽  
...  
Keyword(s):  
Case Report ◽  
Living Donor ◽  
Intestinal Transplantation
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