1. Indications and successes of intestinal transplantation in children in the 21st century: A retrospective cohort study.
- Author
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Lacaille F, Boluda ER, Gupte G, Hind J, Sturm E, Hilberath J, Herlenius G, D'Antiga L, Pietrobattista A, Hernandez F, Sharif K, Vilca-Melendez H, Nadalin S, Colledan M, and Chardot C
- Subjects
- Humans, Retrospective Studies, Child, Male, Female, Child, Preschool, Infant, Treatment Outcome, Adolescent, Intestinal Failure, Short Bowel Syndrome surgery, Intestinal Diseases surgery, Europe, Parenteral Nutrition, Intestines transplantation
- Abstract
Aims: To report the results and successes of intestinal transplantation (ITx) in the most active European centres, to emphasize that, although it is a difficult procedure, it should remain a therapeutic option for children with total, definitive and complicated intestinal failure when intestinal rehabilitation fails., Methods: We retrospectively collected data about all patients less than 18 receiving an ITx from 2010 to 2022 in 8 centres, and outcomes in July 2022., Results: ITx was performed in 155 patients, median age 6.9 years, in 45% for short bowel syndromes, 22% congenital enteropathies, 25% motility disorders, and 15% re-transplantations. Indications were multiple in most patients, intestinal failure-associated liver disease in half. The graft was in 70% liver-containing. At last follow up 64% were alive, weaned from parenteral nutrition, for 7.9 years; 27% had died and the graft was removed in 8%, mostly early after ITx., Discussion: ITx, despite its difficulties, can give a future to children with complicated intestinal failure. It should be considered among the therapeutic options offered to patients with a predicted survival rate lower than that after ITx. Patients should be early discussed within multidisciplinary teams in ITx centres, to avoid severe complications impacting the results of ITx, or even to avoid ITx., Competing Interests: Declaration of competing interest The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2024
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