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Updated: Mar 6, 2026
Small Bowel Transplantation In Mice
Published on: August 20, 2007
Long-term outcomes of living-related small intestinal transplantation in children: A single-center experience
Sandra Garcia Aroz1, Ivo Tzvetanov1, Elizabeth Anne Hetterman2
1Division of Transplantation, Department of Surgery, University of Illinois, Chicago, IL, USA.
Insights
Living donor intestinal transplantation offers a viable solution for children with irreversible intestinal failure. This approach supports growth and improves quality of life, with many patients achieving long-term graft function.
Area of Science:
- Pediatric Surgery
- Transplantation Immunology
- Gastroenterology
Background:
- Irreversible intestinal failure in children poses significant challenges for growth and nutrition.
- Current management strategies may be insufficient for long-term pediatric health.
Purpose of the Study:
- To evaluate the efficacy and outcomes of living-related intestinal transplantation in pediatric patients.
- To assess graft survival, patient survival, and quality of life post-transplantation.
Main Methods:
- Retrospective analysis of 13 living-related intestinal transplantations in 10 children (2002-2013).
- Grafts included isolated intestinal or combined liver-intestinal transplants.
- Immunosuppression involved thymoglobulin induction, tacrolimus, and steroids.
Main Results:
- Seven of 10 children are alive with functioning grafts and good quality of life, with 6 having >10 years follow-up.
- Average time to oral diet initiation was 32 days; median ileostomy takedown was 77 days.
- Observed improved growth and weight gain in the first 1-3 years post-transplant, followed by stabilization.
Conclusions:
- Living donor intestinal transplantation is a feasible alternative for managing irreversible intestinal failure in children.
- The procedure supports long-term nutritional needs, growth, and quality of life.
- Long-term follow-up indicates sustained graft function and patient well-being.
Abstract:
Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6). The immunosuppression protocol consisted of induction with thymoglobulin and maintenance therapy with tacrolimus and steroids. Seven of 10 children are currently alive with a functioning graft and good quality of life. Six of the seven children who are alive have a follow-up longer than 10 years. The average time to initiation of oral diet was 32 days (range, 13-202 days). The median day for ileostomy takedown was 77 (range, 18-224 days). Seven children are on an oral diet, and one of them is on supplements at night through a g-tube. We observed an improvement in growth during the first 3 years post-transplant and progressive weight gain throughout the first year post-transplantation. Growth catch-up and weight gain plateaued after these time periods. We concluded that living donor intestinal transplantation potentially offers a feasible, alternative strategy for long-term treatment of irreversible intestinal failure in children.
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