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Related Experiment Videos

Pediatric intestinal transplantation.

M López-Santamaría1, M Gámez, M Murcia

  • 1Unit of Pediatric Liver Transplantation, Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain. mlopez.hulp@salud.madrid.org

Transplantation Proceedings
|September 10, 2003
PubMed
Summary

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Paediatric intestinal transplantation (IT) offers a life-saving treatment for children with intestinal failure (IF). However, high morbidity and mortality persist, alongside a critical shortage of suitable donors for very low-weight infants requiring combined liver-small bowel transplants.

Area of Science:

  • Pediatric Surgery
  • Transplantation Medicine
  • Gastroenterology

Background:

  • Intestinal failure (IF) in children poses significant management challenges.
  • Parenteral nutrition is insufficient for some IF cases, necessitating advanced interventions.
  • Paediatric intestinal transplantation (IT) is a complex but vital treatment option.

Purpose of the Study:

  • To analyze the outcomes of a 5-year paediatric intestinal transplantation program in Spain.
  • To identify challenges and successes in paediatric IT, including donor scarcity.
  • To evaluate the efficacy of isolated intestinal transplantation (IIT) versus combined liver-small bowel transplantation (LSBT).

Main Methods:

  • Retrospective analysis of 18 paediatric candidates for IT over a 5-year period.

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  • Categorization of IF causes: short bowel syndrome, motility disorders, and congenital epithelial disorders.
  • Documentation of transplant types: LSBT, isolated intestinal transplantation (IIT), and multivisceral transplantation (MVT).

    • Main Results:

    • Eight candidates remained on the waiting list; four died before transplantation, primarily infants awaiting LSBT.
    • Five children underwent successful transplantation (2 IIT, 3 LSBT).
    • Post-transplant outcomes varied: two patients achieved normal diet, two died from complications (hemorrhage, lymphoproliferative disease), and one experienced graft loss due to rejection.

    Conclusions:

    • Paediatric intestinal transplantation (IT) is associated with high morbidity and mortality.
    • IT remains the sole viable treatment for children with intestinal failure unresponsive to parenteral nutrition.
    • A critical shortage of suitable donors for very low-weight infants needing LSBT presents a significant challenge.