Transition from gastrostomy to oral feeding following renal transplantation

Area of Science:

• Pediatric Nephrology
• Gastroenterology
• Transplantation Surgery

Background:

• Gastrostomy button (GB) feeding offers advantages for pediatric patients with chronic kidney disease on dialysis.
• Limited data exists regarding the transition to oral feeding post-renal transplantation in young children, particularly those under two years old.

Purpose of the Study:

• To evaluate the transition to oral feeding in children who previously required gastrostomy button feeding, following renal transplantation.
• To compare outcomes for children initiating gastrostomy button feeding before versus after two years of age.

Main Methods:

• Retrospective analysis of 22 children (under 5 years at GB insertion) over 14 years.
• Comparison of 10 children (Group 1: <2 years at GB insertion) with 6 children (Group 2: 2-5 years at GB insertion).
• Exclusion of 6 children due to factors like cognitive impairment or tongue tie.

Main Results:

• All 16 analyzed children successfully transitioned to normal oral feeding within 10 months post-transplantation.
• Median duration of GB feeding post-transplant was 0.3 years for Group 1 and 0.2 years for Group 2 (p=0.2).
• No significant delay in oral feeding transition was observed for children with normal cognition and no other precluding factors.

Conclusions:

• Children under two years requiring gastrostomy button feeding can achieve successful oral feeding transition post-renal transplant.
• Individualized family support is crucial during the potentially anxious transition period.
• Gastrostomy button feeding is a viable option for nutritional support in pediatric renal transplant candidates.