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Intestinal transplantation for short gut syndrome attributable to necrotizing enterocolitis
G Vennarecci1, T Kato, E P Misiakos
1Department of Surgery, Division of Liver and Gastrointestinal Transplantation, University of Miami School of Medicine, Miami, Florida 33136, USA.
Pediatrics
|February 2, 2000
Summary
Intestinal transplantation offers a life-saving option for infants with necrotizing enterocolitis (NEC)-associated short gut syndrome (SGS) and TPN dependence. This procedure can successfully wean patients from TPN, improving their quality of life.
Area of Science:
- Pediatric Surgery
- Transplantation Medicine
- Neonatal Care
Background:
- Necrotizing enterocolitis (NEC) is a severe neonatal condition often requiring extensive bowel resection.
- Short gut syndrome (SGS) and dependence on total parenteral nutrition (TPN) can result from NEC treatment.
- Intestinal transplantation is a critical intervention for life-threatening SGS in pediatric patients.
Purpose of the Study:
- To review the experience with intestinal transplantation for SGS secondary to NEC.
- To analyze presentation, natural history, timing, and outcomes of these complex cases.
Main Methods:
- Retrospective chart review of pediatric patients undergoing intestinal transplantation for NEC.
- Data collected from August 1994 to March 1999 at the University of Miami.
Main Results:
- Eleven transplants were performed on 10 pediatric patients (median age 1.75 years).
- Transplantation was indicated for liver failure (8 patients) or sepsis (2 patients).
- Overall 1- and 3-year survival was 60%, with 6 survivors weaned off TPN.
Conclusions:
- Intestinal transplantation yields reasonable outcomes for NEC-associated SGS with TPN complications.
- Transplantation can replace diseased organs, eliminate TPN dependence, and enhance quality of life.
- Early consideration and referral for intestinal transplantation are recommended for eligible patients.