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Three-Year Prospective Follow-up of Potential Pediatric Candidate for Intestinal Transplantation
Transplantation Proceedings
|November 8, 2018
Summary
Intestinal failure-associated liver disease (IFALD) is a poor prognostic factor in pediatric intestinal failure (IF). Intestinal transplantation (ITx) indications, such as IFALD or loss of parenteral nutrition access, appear applicable for IF patients.
Area of Science:
- Pediatric Gastroenterology
- Transplantation Surgery
- Clinical Research
Background:
- Intestinal transplantation (ITx) is a vital treatment for refractory intestinal failure (IF).
- Indications and optimal timing for ITx remain debated due to the unpredictable course of IF.
- Identifying prognostic factors is crucial for guiding ITx referral decisions.
Purpose of the Study:
- To identify prognostic factors influencing referral to an intestinal transplantation facility.
- To evaluate the applicability of current ITx indications in pediatric IF patients.
Main Methods:
- Prospective, multi-institutional cohort study in Japan.
- Enrolled pediatric patients (<18 years) with IF on parenteral nutrition >6 months.
- Followed 72 patients for 3 years, analyzing survival and performance status.
Main Results:
- Overall 3-year survival rate was 95%.
- Intestinal failure-associated liver disease (IFALD) significantly impacted survival (86% vs. 97%, P=.0003).
- Patients meeting ITx criteria had lower 3-year survival (82% vs. 97%, P=.034).
Conclusions:
- IFALD is a significant poor prognostic factor in pediatric IF.
- Current ITx indications (IFALD or loss of >2 parenteral nutrition access sites) appear clinically relevant and applicable.
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