title: The role of intestinal transplantation in the management of babies with extensive gut resections.
abstract: OBJECTIVE
  Modern neonatal care, surgical treatment, and total parenteral nutrition (TPN) have improved survival rate for babies with extensive gut resections. The authors examined the role of intestinal transplantation in the treatment of these patients.
  
  
  METHODS
  The authors reviewed all pediatric intestinal transplants performed for short bowel syndrome at our center (70 transplants performed between Aug 1994 and Feb 2002). Factors affecting patient survival were analyzed.
  
  
  RESULTS
  Older patient age at the time of transplant was a significant factor favorably affecting patient survival (P =.031). Trends toward better survival rates were observed in those transplants performed more recently (P =.063), in those patients with greater body weight (P =.084), in those not hospitalized at the time of transplant (P =.14), and in those without concomitant liver failure (P =.12). Three-year survival rate for patients greater than age 2 years and without liver failure was 90%. However, 32% of our recipients underwent transplant at age less than one year, and most in this group (75%) had concomitant liver failure.
  
  
  CONCLUSIONS
  For babies with irreversible intestinal failure, intestinal transplantation is a life-saving option. Results, which have recently improved, are best when transplantation compliments more conservative surgical treatments and TPN. However, there is a subset of patients who have liver disease early requiring urgent transplant.
authors.affiliation: Division of Liver and GI Transplant, and Department of Anesthesia, University of Miami, School of Medicine, Miami, FL, USA.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Naveen
authors.initials: N
authors.lastname: Mittal
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: David
authors.initials: D
authors.lastname: Levi
authors.forename: Noriyo
authors.initials: N
authors.lastname: Yamashiki
authors.forename: Barbara
authors.initials: B
authors.lastname: Miller
authors.forename: Monica
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Phillip
authors.initials: P
authors.lastname: Ruiz
authors.forename: Juan
authors.initials: J
authors.lastname: Madariaga
authors.forename: Jose
authors.initials: J
authors.lastname: Nery
authors.forename: Barry
authors.initials: B
authors.lastname: Gelman
authors.forename: John
authors.initials: J
authors.lastname: Thompson
authors.forename: Anthony
authors.initials: A
authors.lastname: Gyamfi
authors.forename: Andreas
authors.initials: A
authors.lastname: Tzakis
mesh_terms: D000367:Age Factors; D001835:Body Weight; D002675:Child, Preschool; D020345:Enterocolitis, Necrotizing / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000601:surgery; D006627:Hirschsprung Disease / Q000601:surgery; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007223:Infant; D007409:Intestinal Atresia / Q000601:surgery; D045822:Intestinal Volvulus / Q000601:surgery; D007422:Intestines / Q000002:abnormalities / Q000601:surgery / Q000637:transplantation*; D017093:Liver Failure / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D016035:Pancreas Transplantation / Q000401:mortality; D010289:Parenteral Nutrition, Total; D012086:Reoperation / Q000401:mortality; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000150:complications / Q000401:mortality / Q000601:surgery*; D013270:Stomach / Q000637:transplantation; D015996:Survival Rate