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Pediatric intestinal transplantation
Eliza J Lee1, George V Mazariegos1, Geoffrey J Bond1
1The Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, 4401 Penn Ave, 6FP, Pittsburgh, PA 15224, United States of America.
Insights
Pediatric intestinal transplantation (ITx) offers improved survival and enteral autonomy for children with intestinal failure. This review covers ITx history, indications, immunosuppression, complications, and outcomes.
Area of Science:
- Pediatric surgery
- Transplantation immunology
- Gastroenterology
Background:
- Intestinal transplantation (ITx) has evolved significantly since the 1960s.
- Improvements in donor management, organ preservation, operative techniques, and immunosuppression have enhanced outcomes.
- Pediatric patients with intestinal failure now have opportunities for enteral autonomy and long-term survival.
Purpose of the Study:
- To review the history of intestinal transplantation and rehabilitation in pediatric patients.
- To discuss current indications for ITx in children.
- To outline immunosuppression strategies, post-operative complications, and outcomes.
Main Methods:
- Literature review focusing on pediatric intestinal transplantation.
- Synthesis of historical data and current clinical practices.
- Analysis of outcomes and quality of life post-transplant.
Main Results:
- Intestinal transplantation has progressed from experimental to a viable option for select pediatric cases.
- Key factors influencing success include advancements in surgical techniques and immunosuppressive regimens.
- Post-transplant management involves addressing common complications and monitoring long-term quality of life.
Conclusions:
- Pediatric intestinal transplantation provides a life-saving option for children with intestinal failure.
- Continued research and clinical experience are crucial for optimizing patient outcomes.
- Multidisciplinary care is essential for managing complex ITx cases and improving long-term survival.
Abstract:
Advancements in donor management, organ preservation and operative techniques, as well as immunosuppressive therapies, have provided children with intestinal failure and its complications a chance not only for enteral autonomy but also long-term survival through intestinal transplantation (ITx). First described in the 1960's, experience has grown in managing these complex patients both pre- and post-transplant. The goals of this review are to provide a brief history of intestinal transplantation and intestinal rehabilitation in pediatric patients, followed by focused discussions of the indications for ITx, induction and maintenance immunosuppression therapies, common post-operative complications, and outcomes/quality of life post-transplant.
