title: [Activity of a pediatric intestinal transplantation program in Spain].
abstract: OBJECTIVE
  To analyze the outcome of children with intestinal failure (IF) included as candidates for intestinal transplantation (IT). Patients, Eight out of 23 children with IF assessed since July 1997 met criteria for IT and were included on the waiting list. The causes of IT were Short Bowel Syndrome (SBS) in 6 and Microvillus Inclusion Disease (MID) in 2. The indication of IT were end stage liver disease (ESLD) in 5 (related to total parenteral nutrition administration, TPN), progressive hepatic fibrosis in 2 and loss of venous access in 1. The patients with ESLD were included for combined liver-small bowel transplantation (LSBT) and the remaining for isolated intestinal transplantation (IIT).
  
  
  RESULTS
  Two children died waiting for LSBT, 4 patients are on the waiting list, 2 for LSBT and 2 for IIT (length of stay: 4-11 months). Two children were transplanted, one with IIT in a 2.5 years old boy with MID, and one with LSBT in a 22 months girl with SBS and ESLD. Both patients recovered intestinal function after transplantation and are a live (follow-up of 19 and 10 months respectively). The LSBT's patient is under treatment for postransplant lymphoproliferative disease (PTLD).
  
  
  CONCLUSIONS
  The lack of suitable donors for the small children candidate to IT explains the long period of stay on the waiting list and the high pretransplant mortality. Two strategies are possible; early referral of children with IF to a transplant center and surgical techniques like ex vivi-hepatic reductions of the LSB graft.
authors.affiliation: Unidad de Trasplantes Digestivos, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid.
authors.forename: M
authors.initials: M
authors.lastname: López Santamaría
authors.forename: M
authors.initials: M
authors.lastname: Gámez
authors.forename: J
authors.initials: J
authors.lastname: Murcia
authors.forename: N
authors.initials: N
authors.lastname: Leal
authors.forename: E
authors.initials: E
authors.lastname: de Vicente
authors.forename: Y
authors.initials: Y
authors.lastname: Quijano
authors.forename: J
authors.initials: J
authors.lastname: Nuño
authors.forename: J
authors.initials: J
authors.lastname: Larrauri
authors.forename: E
authors.initials: E
authors.lastname: Frauca
authors.forename: M
authors.initials: M
authors.lastname: Molina
authors.forename: J
authors.initials: J
authors.lastname: Sarriá
authors.forename: G
authors.initials: G
authors.lastname: Prieto
authors.forename: R
authors.initials: R
authors.lastname: Lama
authors.forename: P
authors.initials: P
authors.lastname: Jara
authors.forename: I
authors.initials: I
authors.lastname: Polanco
authors.forename: J
authors.initials: J
authors.lastname: Tovar
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D018579:Patient Selection; D010372:Pediatrics / Q000458:organization & administration*; D013030:Spain; D019737:Transplants; D016896:Treatment Outcome; D014850:Waiting Lists