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Organization and outcomes of multidisciplinary intestinal failure teams

Patrick J Javid1, Danielle Wendel2, Simon P Horslen2

  • 1Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA.

Seminars in Pediatric Surgery
|October 22, 2018
PubMed

Insights

Multidisciplinary intestinal failure programs have significantly improved outcomes for children with intestinal failure. These comprehensive programs have led to survival rates exceeding 90% through advances in care.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Innovation
  • Healthcare Management

Background:

  • Multidisciplinary intestinal failure programs have evolved significantly over the past two decades.
  • These programs originated from transplantation services and now offer comprehensive care for pediatric intestinal failure patients and their families.
  • They serve as a crucial foundation for outcomes research and clinical trials in pediatric intestinal failure.

Purpose of the Study:

  • To outline the history and composition of multidisciplinary intestinal failure programs.
  • To emphasize the long-term patient outcomes reported by these programs.
  • To highlight the role of these programs in advancing the care of children with intestinal failure.

Main Methods:

  • Review of historical development and program structures.
  • Analysis of reported long-term patient outcomes from multidisciplinary programs.
  • Identification of key advancements contributing to improved survival rates.

Main Results:

  • Children with intestinal failure now have a favorable long-term prognosis with survival rates routinely exceeding 90%.
  • Key advancements include safe chronic parenteral nutrition (PN) delivery, innovative bowel lengthening techniques, vascular access preservation, and sepsis prevention.
  • Multidisciplinary programs are considered the primary driver of these improved outcomes.

Conclusions:

  • Multidisciplinary intestinal failure programs are essential for comprehensive patient management.
  • These programs have transformed the prognosis for children with intestinal failure.
  • Continued development and support of these programs are vital for ongoing progress in the field.

Keywords:
Intestinal failureIntestinal transplantationMultidisciplinaryPediatricShort bowel syndrome

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