Small bowel transplantation.
Small bowel transplantation is reviewed with particular reference to its role in the management of chronic intestinal failure in children. The complications of administering parenteral nutrition and the indications for considering small bowel transplantation are discussed. The unique clinical problems of small bowel transplantation include preservation/reperfusion injury, post operative dysmotility, malabsorption, abnormal permeability especially during rejection episodes, sepsis, the specific rehabilitation needs of the child and long term monitoring of graft function. International records incorporating over 300 transplants world wide: two thirds in children in 31 separate centres, show that results are variable but improving. The biggest centres have a three-year survival of 65% although a learning curve effect is evident is smaller centres. Small bowel transplantation is a complex surgical and medical enterprise, but it has been shown to be an effective means of treating chronic intestinal failure and should be considered in those patients who are experiencing life threatening complications related to the administration of parenteral nutrition.
Beath
S V
SV
Birmingham Children's Hospital, West Midlands, United Kingdom.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D012720:Severity of Illness Index; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome