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Pediatric small bowel transplantation: A single-center experience from Turkey
Cem Tuğmen1, Maşallah Baran, İsmail Sert
1Department of Organ Transplantation and General Surgery, Sağlık Bilimleri University İzmir Tepecik Training and Research Hospital, İzmir, Turkey. mbaran2509@gmail.com.
Summary
Small bowel transplantation (SBTx) offers hope for intestinal failure patients. Challenges include managing acute cellular rejection and infections, with limited donor availability in Turkey impacting pediatric cases.
Area of Science:
- Pediatric Surgery
- Transplantation Immunology
- Gastroenterology
Background:
- Small bowel transplantation (SBTx) is a critical treatment for intestinal failure.
- İzmir Tepecik Training Research Hospital is Turkey's sole pediatric intestinal transplant center.
Purpose of the Study:
- To evaluate the outcomes of pediatric small bowel transplantation in Turkey.
- To identify challenges and successes in managing SBTx patients.
Main Methods:
- Retrospective analysis of seven isolated SBTxs in six pediatric patients (2010-2016).
- Data collected from medical charts and hospital databases.
- Grafts from deceased donors (one child, six adults).
Main Results:
- 1-year patient and graft survival rates were 71%.
- Acute cellular rejection (ACR) occurred in 57% of patients within 2 months.
- Infections (fungal, bacterial, EBV) were common, impacting outcomes.
Conclusions:
- SBTx is a viable option for pediatric intestinal failure.
- Managing ACR and infections remains a significant challenge.
- Limited availability of suitable cadaveric donors for pediatric SBTx in Turkey is a major hurdle.