Small bowel and liver/small bowel transplantation in children.
A clinical trial of intestinal transplantation was initiated at the University of Pittsburgh in May 1990. Eleven children received either a combined liver/small bowel graft (n = 8) or an isolated small bowel graft (n = 3). Induction as well as maintenance immunosuppression was with FK-506 and steroids. Four patients were male, and seven were female; the age range was 6 months to 10.2 years. There were 3 deaths (all in recipients of the combined liver/small bowel graft), which were attributed to graft-versus-host disease (n = 1), posttransplant lymphoproliferative disease (n = 1), and biliary leak (n = 1). Transplantation of the intestine has evolved into a feasible operation, with an overall patient and graft survival rate of 73%. These survivors are free of total parenteral nutrition, and the majority are home. These encouraging results justify further clinical trials.
Reyes
J
J
Department of Surgery, University of Pittsburgh, PA 15213.
Tzakis
A G
AG
Todo
S
S
Nour
B
B
Starzl
T E
TE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007223:Infant; D007410:Intestinal Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D017093:Liver Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate