Pediatric intestinal transplantation

Semin Pediatr Surg. 2017 Aug;26(4):241-249. doi: 10.1053/j.sempedsurg.2017.07.007. Epub 2017 Jul 25.

Abstract

The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term survival. As experience has grown, newer diseases, with more systemic manifestations have arisen as potential indications for transplant. After discussing the historical developments of intestinal transplant as a backdrop, this review focuses on the specific pre-operative indications for transplant as well as the great success that intestinal rehabilitation has witnessed over the past decade. A detailed discussion of evolution of immunosuppressive strategies is followed a general review of the common infectious complications experienced by children after intestinal transplant as well as the current long- and short-term results, including a section on new research on the quality of life in this challenging population of patients.

Keywords: Immunosuppression; Infection; Intestinal failure; Intestinal transplant; Post-transplant lymphoproliferative disease; Quality of life.

Publication types

  • Review

MeSH terms

  • Child
  • Graft Rejection / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intestinal Diseases / etiology
  • Intestinal Diseases / surgery*
  • Intestines / transplantation*
  • Organ Transplantation / methods*
  • Perioperative Care / methods
  • Treatment Outcome

Substances

  • Immunosuppressive Agents