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Updated: Aug 19, 2026
Tissue Engineering of the Intestine in a Murine Model
Published on: December 1, 2012
[Intestinal rehabilitation for children with short bowel syndrome]
T Dijkstra1, G Dijkstra, C M A Bijleveld
1Afd. Kindergeneeskunde, Universitair Medisch Centrum Groningen, Beatrix Kinderkliniek, Postbus 30.001, 9700 RB Groningen.
Insights
Intestinal rehabilitation can help children with short bowel syndrome reduce dependence on total parenteral nutrition (TPN) and improve growth, potentially avoiding the need for small bowel transplantation.
Area of Science:
- Pediatric Gastroenterology
- Transplantation Surgery
- Intestinal Rehabilitation
Background:
- Short bowel syndrome (SBS) often leads to intestinal failure and dependence on total parenteral nutrition (TPN) in children.
- Small bowel transplantation is a potential treatment for SBS, but carries significant risks and complexities.
- Early referral for intestinal rehabilitation is crucial for managing SBS.
Observation:
- Three pediatric patients with SBS and TPN dependence were evaluated for small bowel transplantation.
- One patient also presented with progressive liver failure, indicating a need for combined small bowel/liver transplantation.
- All patients were enrolled in an inpatient intestinal rehabilitation program.
Findings:
- The rehabilitation program involved systematic assessment, optimized nutrition (enteral and parenteral), and prevention of complications like catheter sepsis.
- All three children showed partial weaning from TPN and improved growth.
- Consequently, none of the children were listed for small bowel transplantation.
Implications:
- Intestinal rehabilitation should be considered a vital component of intestinal transplantation programs for children with SBS.
- Early intervention through rehabilitation can potentially alter the need for transplantation.
- This approach may improve outcomes and reduce the burden of TPN in pediatric SBS patients.
Abstract:
Three children, 2 boys aged 5 and 4 years, and 1 girl aged 2 years, who suffered from intestinal failure as a result of a short bowel syndrome and who were dependent on total parenteral nutrition (TPN), were screened for small bowel transplantation. The girl also had progressive liver failure. Each child had a clear indication for either isolated small bowel or combined small bowel/liver transplantation. All three children were enrolled in an intestinal rehabilitation program because they were referred early. The intestinal rehabilitation consisted of a systematic analysis of the absorptive capacity of the residual intestine, optimizing enteral and parenteral feeding, prevention of catheter sepsis and further deterioration of liver function. The rehabilitation was performed in an in-patient setting. All three children were partially weaned from TPN, while their growth improved. None of the children were consequently listed for small bowel transplantation. When a child is initially referred for small bowel transplantation, intestinal rehabilitation should be considered as part of an intestinal transplantation program.
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