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Gastrostomy tubes appear to be safe following pediatric orthotopic heart transplant

Rick D Vavolizza1, David F Grabski2, Daniel E Levin3

  • 1University of Virginia School of Medicine, Charlottesville, Virginia.

Pediatric Transplantation
|February 21, 2019
PubMed

Insights

Gastrostomy tube (GT) placement is safe for pediatric patients with heart transplants who are on immunosuppressants. This study found no major complications in these patients, suggesting it

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Immunology

Background:

  • Oral aversion is a common reason for gastrostomy tube (GT) placement in children.
  • Congenital heart disease (CHD) patients needing orthotopic heart transplant (OHT) may develop oral aversion.
  • The safety of GT placement in immunosuppressed pediatric OHT patients is not well-documented.

Purpose of the Study:

  • To evaluate the safety of gastrostomy tube (GT) placement in pediatric patients who have undergone orthotopic heart transplant (OHT).
  • To assess the risk of wound site complications in immunosuppressed OHT recipients requiring GT placement.

Main Methods:

  • Retrospective case series of pediatric OHT recipients who had GT placement between January 1, 2009, and August 1, 2018.
  • Data collected on major GT complications (wound breakdown, infection, leakage, ileus, emesis) and minor complications (granulation tissue).

Main Results:

  • Six pediatric OHT patients underwent GT placement during the study period.
  • No major GT complications (30-day or 90-day) were observed.
  • One patient experienced excessive granulation tissue; no infections or other major adverse events occurred.

Conclusions:

  • Gastrostomy tube placement appears safe for pediatric OHT patients on immunosuppressive therapy who have feeding difficulties.
  • This study provides initial evidence on the safety profile of GTs in this vulnerable population.
  • Findings may assist clinicians in managing feeding support for pediatric OHT recipients.
Abstract

Keywords:
G-tubecomplicationsgastrostomygastrostomy tubeheart transplantpediatrics

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