Living-related bowel transplantation to treat short bowel syndrome in a four-year-old child: a case report.
OBJECTIVE
Short bowel syndrome (SBS) is an extremely challenging clinical problem in children. Although many patients can be maintained for a period of time on total parenteral nutrition (TPN), many of these children suffer from the morbidity and mortality associated with sequential central line infections, venous thromboses, and TPN-induced liver failure. Intestinal transplantation often is the only chance for long-term survival. Unfortunately, many children die every year waiting for size-matched cadaveric intestine to become available.


METHODS
After our success with living-related bowel transplantation in adults, the authors successfully transplanted 150 cm of maternal ileum into a 4-year-old 10-kg child with profound malnutrition from SBS and advanced TPN-induced liver failure. Because of the size mismatch, the abdominal cavity could not be closed primarily. The defect was covered with absorbable mesh and subsequently with skin graft.


RESULTS
The patient is home with excellent bowel and liver function, off hyperalimentation, and on a regular diet. No rejection has been encountered.


CONCLUSIONS
Living-related intestinal transplantation is a life-saving alternative to cadaveric intestinal transplantation in children with short bowel syndrome.
Holterman
M J
MJ
Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Holterman
A L
AL
Carrol
R
R
John
E
E
Testa
G
G
Sankary
H
H
Cohen
M
M
Grevious
M
M
Abcarian
H A
HA
Benedetti
E
E
D002675:Child, Preschool; D020139:Gastroschisis / Q000150:complications; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D007165:Immunosuppression Therapy; D019520:Living Donors; D008297:Male; D009035:Mothers; D012778:Short Bowel Syndrome / Q000601:surgery*