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Published on: August 20, 2007
Pediatric intestine and multivisceral transplant
Mohamed Maklad1, George Mazariegos, Armando Ganoza
1Hillman Center for Pediatric Transplantation, Thomas E. Starzl Transplantation Institute, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
Intestinal and multivisceral transplantation (ITx, MVTx) offers life-saving treatment for children with intestinal failure (IF). While outcomes improve, long-term graft function remains a significant challenge in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Transplantation Surgery
- Organ Failure Management
Background:
- Intestinal failure (IF) in children requires advanced management, including parenteral nutrition (PN).
- Intestinal transplantation (ITx) and multivisceral transplantation (MVTx) are critical interventions for irreversible IF and its complications.
- Pediatric IF presents unique etiological and management considerations compared to adults.
Conclusions:
- ITx and MVTx are essential treatments for pediatric IF, offering improved survival rates.
- Ongoing challenges include optimizing long-term graft function and addressing pediatric-specific surgical issues.
- Continued research and updates in management protocols are crucial for improving outcomes in pediatric transplantation.
Purpose Of Review:
Intestinal and multivisceral transplantation (ITx, MVTx) is the cornerstone in treatment of irreversible intestinal failure (IF) and complications related to parenteral nutrition. This review aims to highlight the unique aspects of the subject in pediatrics.
Recent Findings:
Etiology of intestinal failure (IF) in children shares some similarity with adults but several unique considerations when being evaluated for transplantation will be discussed. Owing to significant advancement in IF management and home parenteral nutrition (PN), indication criteria for pediatric transplantation continues to be updated. Outcomes have continued to improve with current long-term patient and graft survival in multicenter registry reports reported at 66.1% and 48.8% at 5 years, respectively. Pediatric specific surgical challenges such abdominal closure, post transplantation outcomes, and quality of life are discussed in this review.
Summary:
ITx and MVTx remain lifesaving treatment for many children with IF. However long-term graft function is still a major challenge.
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