Intestinal and multivisceral transplantation: dynamics of nutritional management and functional autonomy.
OBJECTIVE
The objective of this study was to describe the dynamics of nutrition management of intestinal transplant recipients and allograft functional autonomy.


METHODS
Intestinal absorptive functions and recipient nutritional status were monitored during the 12-month study period. Absorption was evaluated with D-xylose absorption and fecal fat excretion. Indices for nutrition were body weight, anthropometric measures, and serum albumin.


RESULTS
Before transplant, all patients were total parenteral nutrition (TPN) dependent and well nourished. By the first postoperative month, all 22 recipients were tolerating enteral feeding. By 3 months, all recipients had begun oral feeding, with 13 off TPN and 7 off enteral feeds. By 6 months, 16 recipients were off TPN, and by the end of the 12th month, 17 (77%) were free of TPN. Although all 22 recipients were completely weaned off TPN during the first posttransplant year, 10 required temporary reinstitution of therapy at different points. Full nutritional autonomy was achieved at 3 months by 3 recipients, at 6 months by 8 recipients, and at 12 months by 12 (55%) recipients.


CONCLUSIONS
These results reflect our early experience that led to surgical refinement of the operation and evolution of the recipient postoperative management. Nonetheless, even in this initial cohort, most of the engrafted intestines restored the recipient nutritional autonomy, and all survivors remained well nourished.
Rovera
Giuseppe M
GM
Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213-2582, USA.
Schoen
Robert E
RE
Goldbach
Beth
B
Janson
Douglas
D
Bond
Geoffrey
G
Rakela
Jorge
J
Graham
Toby O
TO
O'Keefe
Stephen
S
Abu-Elmagd
Kareem
K
D000328:Adult; D000886:Anthropometry; D001835:Body Weight; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D007410:Intestinal Diseases / Q000601:surgery*; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support; D016035:Pancreas Transplantation; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D012709:Serum Albumin / Q000032:analysis; D013270:Stomach / Q000637:transplantation; D013997:Time Factors; D014184:Transplantation, Homologous
D012709:Serum Albumin