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[Intestinal transplantation. First experience in Spain].

M López Santamaría1, E de Vicente, M Gámez

  • 1Dpto. de Cirugía Pediátrica, Unidad de Trasplantes Digestivos, Hospital Universitario, La Paz, Madrid.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|May 8, 2001
PubMed
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The first intestinal transplant (IT) in Spain successfully treated a young boy with microvillous inclusion disease (MID). This life-saving procedure allowed the patient to transition from total parenteral nutrition (TPN) to oral feeding.

Area of Science:

  • Gastroenterology
  • Transplant Surgery
  • Pediatric Surgery

Background:

  • Microvillous inclusion disease (MID) is a rare congenital disorder causing severe secretory diarrhea.
  • Patients with MID often require total parenteral nutrition (TPN) and are at high risk for central venous catheter-related complications.
  • Intestinal transplantation (IT) offers a potential solution for patients with intractable intestinal failure.

Observation:

  • A 3-year-old boy with MID and a history of multiple sepsis episodes underwent an isolated small bowel transplant.
  • The native ileocecal valve and colon were preserved during the procedure.
  • Post-transplant, the patient successfully transitioned to enteral feeding and eventually regular oral intake, discontinuing TPN.

Findings:

  • The patient tolerated enteral feeding within two weeks and was weaned off TPN by day 25.

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  • Complications included a rotavirus infection and a mild rejection episode, both managed successfully.
  • The ileostomy was closed at six months post-transplant, indicating successful graft function.

    • Implications:

    • This case demonstrates the feasibility and success of intestinal transplantation in Spain for pediatric patients with intestinal failure.
    • Preservation of the recipient's native ileocecal valve and colon is possible and may be beneficial.
    • Intestinal transplantation represents a viable therapeutic option for severe cases of MID, improving quality of life.