title: Pediatric small bowel transplantation: A single-center experience from Turkey.
abstract: OBJECTIVE
  Small bowel transplantation (SBTx) is a treatment option for patients with serious parenteral nutrition-related problems in intestinal failure. İzmir Tepecik Training Research Hospital Organ Transplantation Center is still the only pediatric intestinal transplant center in Turkey.
  
  
  METHODS
  This study was approved by the local ethics committee. Patients' data were analyzed from the medical charts and the hospital digital database. Seven isolated SBTxs were performed in six children between 2010 and 2016.
  
  
  RESULTS
  One jejunal segment and six partial jejuno-ileal segments were used for seven transplants. All grafts were retrieved from deceased donors (one child and six adult donors). The six recipients had a mean age of 8.8±6.9 years (9 months to 17 years; M: 4, F: 2). The mean follow-up period of patients was 727±848 (34 to 1950) days. Acute cellular rejection (ACR) rates were 57% (n: 4) in the first 2 months. Graft loss due to severe ACR was seen in one patient. Central line-associated fungal (n: 3, 42%) and bacterial infections (n: 3, 42%) were seen in the first 2 months. Two Epstein-Barr virus (EBV) infections were recorded between 3 and 8 months in two patients. Our 1-year patient and graft survival rates were 71% and 71%, respectively.
  
  
  CONCLUSIONS
  SBTx has become a treatment modality for patients with intestinal failures. Management of ACR and infections are still challenging problems in SBTx. Appropriate-sized cadaveric donors are very limited in Turkey for pediatric intestinal transplantation candidates. Although the number of SBTxs performed was small, this study shows promising results.
authors: Department of Organ Transplantation and General Surgery, Sağlık Bilimleri University İzmir Tepecik Training and Research Hospital, İzmir, Turkey. mbaran2509@gmail.com.
authors: Cem
authors: C
authors: Tuğmen
authors: Maşallah
authors: M
authors: Baran
authors: İsmail
authors: İ
authors: Sert
authors: Ayşe Berna
authors: AB
authors: Anıl
authors: Eyüp
authors: E
authors: Kebapçı
authors: Sait Murat
authors: SM
authors: Doğan
authors: Selçuk
authors: S
authors: Kılınç
authors: Gaye
authors: G
authors: Aydın
authors: Ayşe Gülden
authors: AG
authors: Diniz
authors: Mustafa
authors: M
authors: Ölmez
authors: İbrahim
authors: İ
authors: Pirim
authors: Cezmi
authors: C
authors: Karaca
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology