Nutritional outcomes following pediatric intestinal transplantation.
BACKGROUND
This study sought to describe the long-term nutritional outcomes of children after intestinal transplant (SBT).


METHODS
Between 1991 and March 2005, 30 children received 33 SBT at a single center. Eligibility criteria included patient and graft survival >6 months. Weight, height, albumin, prealbumin, zinc (Zn), and essential fatty acid (EFA) levels were reviewed retrospectively.


RESULTS
The 19 patients who met inclusion criteria had a median age at SBT of 2.9 years. The majority of patients were male, Latino, transplanted for necrotizing enterocolitis and received combined liver-SBT. All patients were weaned off total parenteral nutrition to elemental formula at a mean of 39 days post-SBT. Seventeen of 19 patients were Zn deficient and four patients were EFA deficient post-SBT.


CONCLUSIONS
Pre-SBT most subjects were significantly deficient in anthropometric and biochemical parameters. Post-SBT the mean Z score for weight and height improved significantly at year 1, then leveled off in year 2. Serum protein levels improved from pre-SBT, yet remained low-normal. Zn deficiency was seen frequently after SBT and is under investigation. Children who developed EFA deficiency were on the same formula, receiving inadequate EFA supplementation. Successful SBT was associated with growth and maintenance of serum nutritional parameters but not with significant catch-up growth.
Venick
R S
RS
Department of Pediatrics, UCLA Pediatric GI, The David Geffen School of Medicine, University of California-Los Angeles, PO Box 91752, Los Angeles, CA 90095, USA. Rvenick@mednet.ucla.edu
Farmer
D G
DG
Saikali
D
D
Gordon
S
S
Colangelo
J
J
Reyen
L
L
McDiarmid
S V
SV
Vargas
J H
JH
Ament
M E
ME
Busuttil
R W
RW
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005228:Fatty Acids, Essential / Q000097:blood; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D009747:Nutritional Physiological Phenomena; D018579:Patient Selection; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000502:physiology*; D016896:Treatment Outcome
D005228:Fatty Acids, Essential