Long-term results of intestinal transplantation for pseudo-obstruction in children.
OBJECTIVE
The aim of this study was to determine long-term results of intestinal transplantation in children with pseudo-obstruction, particularly when stomach and colon are not part of the allograft.


METHODS
The authors conducted a case-record review of all children who underwent transplantation at our center for a primary diagnosis of pseudo-obstruction. Supplementary information was obtained from outpatient charts, computerized database, and telephone survey of parents.


RESULTS
Six small bowel and 3 liver-small bowel transplants were carried out in 8 patients between 1993 and 1999. Median follow-up is 40 months (range, 13 to 73 months). Median age at transplantation was 2.7 years (range, 0.7 to 12.8 years). Median graft survival in this series is 15 months (range, 1 day to 71 months). Stomach and colon were excluded from all allografts. Two children died 5 and 368 days after transplant and 2 graft losses occurred in 1 patient. Two children had lymphoproliferative disease; both are alive with functioning grafts. Five survivors with functioning grafts receive full enteral feedings at home. Four of the 5 have had ileostomies closed, and 3 have normal bowel movements.


CONCLUSIONS
Intestinal transplantation without stomach or colon provides children with chronic intestinal pseudo-obstruction with a good quality of life. The underlying disease poses special challenges in management.
Iyer
K
K
Organ Transplantation Program, University of Nebraska Medical Center, Omaha, NE 68198-3285, USA.
Kaufman
S
S
Sudan
D
D
Horslen
S
S
Shaw
B
B
Fox
I
I
Langnas
A
A
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D007418:Intestinal Pseudo-Obstruction / Q000601:surgery*; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D010289:Parenteral Nutrition, Total; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome