Intestinal Transplantation

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 5868 Experts worldwide ranked by ideXlab platform

Thomas E. Starzl - One of the best experts on this subject based on the ideXlab platform.

  • Intestinal Transplantation for patients with short gut syndrome and hypercoagulable states
    Transplantation proceedings, 2000
    Co-Authors: M. Giraldo, Jorge Reyes, John J. Fung, Thomas E. Starzl, Javier Bueno, D Martin, J Colangelo, Kareem Abu-elmagd
    Abstract:

    Intestinal Transplantation has become a life-saving procedure for patients with irreversible Intestinal failure who can no longer be maintained on total parenteral nutrition (TPN).1 This is the first report to address the management policy and efficacy of Intestinal Transplantation as a rescue therapy for patients with Intestinal failure and visceral vascular thrombosis.

  • Cytomegalovirus infection after Intestinal Transplantation in children.
    Clinical Infectious Diseases, 1997
    Co-Authors: Javier Bueno, Kareem Abu-elmagd, Jorge Reyes, H. Furukawa, Samuel A. Kocoshis, Michael Green, Eduardo J. Yunis, William Irish, Satoru Todo, Thomas E. Starzl
    Abstract:

    Although the intestine was one of the first organs to be transplanted experimentally, the clinical evolution of Intestinal Transplantation has remained hindered by technical, immunologic, and infectious complications [1–3]. Recently, with advances in surgical and clinical management and the use of tacrolimus (FK-506) as the principal immunosuppressive drug, actuarial patient and graft survivals at 24 months post-Transplantation have exceeded 74% and 63%, respectively [4]. Infections, however, continue to be a significant cause of morbidity. We have previously reported high rates of late mortality and graft loss due to cytomegalovirus (CMV) infection in our overall experience with adult and pediatric Intestinal transplant recipients [5]. The occurrence of CMV infection following Intestinal Transplantation in children, however, may have differing epidemiological and behavioral characteristics, as has been seen with other organ recipients. A retrospective analysis of our experience with CMV after Intestinal Transplantation in children is the basis of this report.

  • Intestinal Transplantation in 31 adults
    Transplantation proceedings, 1996
    Co-Authors: H. Furukawa, Kareem Abu-elmagd, Jorge Reyes, Thomas E. Starzl, W. Hutson, Js Tabasco-minguillan, Shimon Kusne, S Todo
    Abstract:

    During the last 5 years, Intestinal Transplantation has become a feasible therapeutic option for patients who have irreversible Intestinal failure under tacrolimus (FK 506)-based immunosuppression.1–3 Although there was no mortality in adults during the first 2 years after initiation of our Intestinal Transplantation program, survival rates worsened rapidly over the last 3 years. In this article, we analyze the main contributing factors for the deterioration of patient and graft outcome after adult Intestinal Transplantation.

  • Effect of CMV serology on outcome after clinical Intestinal Transplantation.
    Transplantation proceedings, 1996
    Co-Authors: H. Furukawa, Kareem Abu-elmagd, Jorge Reyes, Thomas E. Starzl, Shimon Kusne, Michael Green, S Todo
    Abstract:

    OVER the last 5 years, Intestinal Transplantation has become a feasible therapeutic option for patients with irreversible Intestinal failure.1 Cytomegalovirus (CMV) infection was shown to be the most frequent viral infection in the Intestinal transplant recipients and to be related to high mortality and morbidity.2,3 In this study, we analyzed the effect of CMV serology of donors and recipients on the outcome of patient and graft survival after Intestinal Transplantation.

  • Cytomegalovirus disease in Intestinal Transplantation
    Transplantation proceedings, 1995
    Co-Authors: H. Furukawa, S Todo, Kareem Abu-elmagd, Shimon Kusne, Rafael Mañez, Michael Green, G. Reyes, Thomas E. Starzl
    Abstract:

    Over the last 4 years, Intestinal Transplantation has become a feasible therapeutic option for patients with irreversible Intestinal failure.1 However, it has been shown that Intestinal transplant recipients have a high incidence of cytomegalovirus (CMV) infection.2 In this study, we analyzed the incidence of CMV disease and CMV-related mortality after Intestinal Transplantation.

Andreas G. Tzakis - One of the best experts on this subject based on the ideXlab platform.

  • Pediatric Intestinal Transplantation: Literature review 2006–2007
    Pediatric Transplantation, 2008
    Co-Authors: Gennaro Selvaggi, Andreas G. Tzakis
    Abstract:

    :  The field of Intestinal Transplantation has rapidly progressed over the last few years, with greatly improved patient and graft survival rates. Pediatric patients actually comprise the majority of individuals referred for Intestinal Transplantation; therefore, most of the current literature on this subject is centered on such group of patients. Issues pertinent to patient selection, indications for Transplantation and management of post-transplant complications run parallel to those issues of appropriate immunosuppressive protocols and avoidance/treatment of rejection, which is still one of the biggest causes of morbidity and mortality. This manuscript reviews what the authors view as the most innovative contributions in the field of Intestinal Transplantation over the last two yr (2006–2007). This review is by no means exhaustive but might serve as a starting point for those clinicians interested in the field.

  • Intestinal Transplantation for short bowel syndrome secondary to gastroschisis
    Journal of Pediatric Surgery, 2006
    Co-Authors: Motoshi Wada, Naveen K Mittal, Tomoaki Kato, John F. Thompson, Gennaro Selvaggi, Yutaka Hayashi, M. Gonzalez, Seigo Nishida, Juan Madariaga, Andreas G. Tzakis
    Abstract:

    Abstract Background/Purpose Gastroschisis is the most frequent cause of pediatric Intestinal Transplantation. This study reviews our experience of Intestinal Transplantation secondary to gastroschisis to elucidate those factors affecting the outcome of children with short bowel syndrome. Methods A retrospective review was performed for children who underwent Intestinal Transplantation for gastroschisis at the University of Miami between June 2003 and August 1994. Results Thirty-two transplants were performed in 28 children with gastroschisis during the study period. Associated Intestinal anomalies were present in 22 infants (atresia [n = 14], volvulus [n = 3], and/or ischemia [n = 16]). Spontaneous prenatal closure of gastroschisis, a rare anomaly associated with bowel atresia and ischemia because of a very small abdominal defect, was seen in 9 patients. Most of the patients had a complicated course and required multiple abdominal surgeries before transplant. Fifteen (53.6%) patients are currently alive at a median follow-up of 23.5 months. Short-term survival rate has significantly improved in recent years. Conclusions Patients with complex gastroschisis and Intestinal anomalies have a significant risk for progression to short bowel syndrome. Intestinal Transplantation can be a lifesaving option and provides a satisfactory outcome for children with short bowel syndrome secondary to gastroschisis.

  • Temporary Elevation of Serum Transaminases After Pediatric Intestinal Transplantation: Incidence and Clinical Correlation in Multivisceral Transplant vs Isolated Intestinal Transplant
    Transplantation proceedings, 2006
    Co-Authors: T. Ueno, Tomoaki Kato, John F. Thompson, Gennaro Selvaggi, Jeffrey J. Gaynor, M. Velasco, Gwenn E. Mclaughlin, E. Hernandez, Andreas G. Tzakis
    Abstract:

    Data were gathered from the records of 51 children of median age 1.5 years who survived more than 6 months after Intestinal Transplantation. Abnormal liver function tests (LFTs) were defined as serum aspartate aminotransferase (AST) greater than 100 IU/L or total bilirubin greater than 2.0 g/dL lasting more than 3 days. Temporary elevation was defined when LFTs returned to normal without graft loss or death. LFT elevation at the time of Transplantation was not included as a temporary LFT elevation. Median follow-up was 36 months. In multivisceral transplant recipients, all patients (n = 34) showed abnormal LFTs at Transplantation that normalized within a median period of 2 days. Temporary LFT elevations were seen in 20 of 34 (59%) in multivisceral Transplantation and 5 of 17 (29%) in isolated Intestinal Transplantation. Median length of elevation was 14 days in multivisceral Transplantation and 12 days in isolated Intestinal Transplantation. Peak AST was 353 ± 190 IU/dL in multivisceral Transplantation and 839 ± 605 IU/dL in isolated Intestinal Transplantation (P = .0059). Events associated with temporary LFT elevations in multivisceral Transplantation were total parental nutrition (TPN) (n = 8), dehydration (n = 2), viral infection (n = 2), others (n = 3), and nonspecific (n = 5). Events in isolated Intestinal Transplantation were posttransplant lymphoproliferative disorder (n = 2), TPN (n = 1), and nonspecific (n = 2). Temporary LFT elevations were commonly seen among pediatric Intestinal recipients, which correlated with events other than rejection. Approximately half of the temporary LFT elevations were associated with no significant clinical events. They resolved spontaneously. Interestingly, the peak AST value was higher in isolated Intestinal Transplantation compared to multivisceral Transplantation.

  • ninety five cases of Intestinal Transplantation at the university of miami
    Journal of Gastrointestinal Surgery, 2002
    Co-Authors: Seigo Nishida, Naveen K Mittal, Tomoaki Kato, Juan Madariaga, D Levi, J Nery, Nicholas S Hadjis, Andreas G. Tzakis
    Abstract:

    Intestinal failure requiring total parenteral nutrition (TPN) is associated with significant morbidity and mortality. Intestinal Transplantation can be a lifesaving option for patients with Intestinal failure who develop serious TPN-related complications. The aim of this study was to evaluate survival, surgical technique, and patient care in patients treated with Intestinal Transplantation. We reviewed data collected from 95 consecutive Intestinal transplants performed between December 1994 and November 2000 at the University of Miami. Fifty-four of the patients undergoing Intestinal Transplantation were children and 41 were adults. The series includes 49 male and 46 female patients. The causes of Intestinal failure included mesenteric venous thrombosis (n = 12), necrotizing enterocolitis (n = 11), gastroschisis (n = 11), midgut volvulus (n = 9), desmoid tumor (n = 8), Intestinal atresia (n = 6), trauma (n = 5), Hirschsprung’s disease (n = 5), Crohn’s disease (n = 5), Intestinal pseudoobstruction (n = 4), and others (n = 19). The procedures performed included 27 isolated intestine transplants, 28 combined liver and intestine transplants, and 40 multivisceral transplants. Since 1998, we have been using daclizumab (Zenepax) for induction of immunosuppression and zoom videoendoscopy for graft surveillance. We began to use intense cytomegalovirus prophylaxis and systemic drainage of the portal vein. The 1-year patient survival rates for isolated Intestinal, liver and Intestinal, and multivisceral Transplantations were 75%, 40%, and 48%, respectively. Since 1998, the 1-year patient and graft survival rates for isolated Intestinal transplants have been 84% and 72%, respectively. The causes of death were as follows: sepsis after rejection (n = 14), respiratory failure (n = 8), sepsis (n = 6), multiple organ failure (n = 4), arterial graft infection (n = 3), aspergillosis (n = 2), post-Transplantation lymphoproliferative disease (n = 2), intracranial hemorrhage (n = 2), and fungemia, chronic rejection, graft vs. host disease, necrotizing enterocolitis, pancreatitis, pulmonary embolism, and viral encephalitis (n = 1 case of each). Intestinal Transplantation can be a lifesaving alternative for patients with Intestinal failure. The prognosis after Intestinal Transplantation is better when it is performed before the onset of liver failure. Rejection monitoring with zoom videoendoscopy and new immunosuppressive therapy with sirolimus, daclizumab, and campath-1H have contributed to the improvement in patient survival.

  • abdominal wall closure after Intestinal Transplantation
    Plastic and Reconstructive Surgery, 2000
    Co-Authors: Ioannis J Alexandrides, Andreas G. Tzakis, Deirdra M Marshall, John R Nery, Seth R Thaller
    Abstract:

    Successful surgical closure of the abdominal wall after either combined or isolated Intestinal Transplantation may present a challenging dilemma for the plastic and reconstructive surgeon because of the following factors: restricted volume of the recipient abdominal cavity; donor-recipient size discrepancies as expressed by the donor to recipient weight ratio; and significant intraoperative edema. The purpose of this investigation is to present clinical experience with 51 consecutive patients who underwent a total of 57 sequential Intestinal Transplantations at the University of Miami-Jackson Memorial Hospital. A retrospective chart review of 36 pediatric (63 percent) and 21 adult (37 percent) Transplantations was performed. Age of the pediatric population ranged from 1 month to 13 years (mean, 2.4 years) and of the adult population from 22 to 55 years (mean, 33.5 years). Several diagnostic classifications necessitated organ Transplantation. Because of insufficient donor graft size for the recipient abdominal cavity in 19 Transplantations (33 percent), several technical modifications were used to achieve anatomic and functional abdominal wall closure in all patients. In summary, the plastic and reconstructive surgeon should have a significant role in the comprehensive planning and management of abdominal wall closure in this challenging group of patients.

H. Furukawa - One of the best experts on this subject based on the ideXlab platform.

  • Impact of Intestinal Transplantation for Intestinal Failure in Japan
    Transplantation proceedings, 2014
    Co-Authors: Takehisa Ueno, H. Furukawa, Motoshi Wada, Ken Hoshino, Shinji Uemoto, Tomoaki Taguchi, Masahiro Fukuzawa
    Abstract:

    Abstract Introduction The prognosis of Intestinal failure has improved dramatically in the past few decades with the development of parenteral nutrition (PN). However, PN-dependent patients still have numerous complications. Intestinal Transplantation can significantly improve their prognosis and quality of life. We report on the impact of Intestinal Transplantation for Intestinal failure in Japan. Methods Intestinal Transplantations have been performed in Japan since 1996. Standardized forms were sent to all known Intestinal Transplantation programs, asking for information on Intestinal Transplantations performed between 1996 and June 31, 2012. All programs responded. Patient and graft survival estimates were obtained using the Kaplan-Meier method and analyzed with the Wilcoxon statistic. Results Five institutions provided data on 24 grafts in 21 patients. There were 12 cadaveric and 12 living related donor transplants. Causes of Intestinal failure included short gut syndrome ( n  = 9), Intestinal motility function disorders ( n  = 11), reTransplantation ( n  = 3), and other ( n  = 1). The overall 1- and 5-year patient survival rates were 86% and 68%, respectively. In cases ( n  = 15) after 2006, the 1-year patient survival rate was 92%, and the 5-year survival rate was 83%. One- and five-year graft survival rates were 87% and 78%, respectively. More than 80% of all current survivors discontinued PN. Conclusions Intestinal Transplantation has become an effective therapy for patients with Intestinal failure who cannot tolerate PN. After 2006, patient and graft survival rates approached rates associated with standard treatment for end-stage Intestinal failure. Further improvements are expected with early referral due to suitable donor organ and pretransplant management.

  • Impact of pediatric Intestinal Transplantation on Intestinal failure in Japan: findings based on the Japanese Intestinal transplant registry
    Pediatric Surgery International, 2013
    Co-Authors: Takehisa Ueno, H. Furukawa, Motoshi Wada, Ken Hoshino, Shinji Uemoto, Tomoaki Taguchi, Masahiro Fukuzawa
    Abstract:

    Introduction We assessed the impact of Intestinal Transplantation on Japanese pediatric patients with Intestinal failure with data from the Japanese Intestinal transplant registry.

  • Cytomegalovirus infection after Intestinal Transplantation in children.
    Clinical Infectious Diseases, 1997
    Co-Authors: Javier Bueno, Kareem Abu-elmagd, Jorge Reyes, H. Furukawa, Samuel A. Kocoshis, Michael Green, Eduardo J. Yunis, William Irish, Satoru Todo, Thomas E. Starzl
    Abstract:

    Although the intestine was one of the first organs to be transplanted experimentally, the clinical evolution of Intestinal Transplantation has remained hindered by technical, immunologic, and infectious complications [1–3]. Recently, with advances in surgical and clinical management and the use of tacrolimus (FK-506) as the principal immunosuppressive drug, actuarial patient and graft survivals at 24 months post-Transplantation have exceeded 74% and 63%, respectively [4]. Infections, however, continue to be a significant cause of morbidity. We have previously reported high rates of late mortality and graft loss due to cytomegalovirus (CMV) infection in our overall experience with adult and pediatric Intestinal transplant recipients [5]. The occurrence of CMV infection following Intestinal Transplantation in children, however, may have differing epidemiological and behavioral characteristics, as has been seen with other organ recipients. A retrospective analysis of our experience with CMV after Intestinal Transplantation in children is the basis of this report.

  • Intestinal Transplantation in 31 adults
    Transplantation proceedings, 1996
    Co-Authors: H. Furukawa, Kareem Abu-elmagd, Jorge Reyes, Thomas E. Starzl, W. Hutson, Js Tabasco-minguillan, Shimon Kusne, S Todo
    Abstract:

    During the last 5 years, Intestinal Transplantation has become a feasible therapeutic option for patients who have irreversible Intestinal failure under tacrolimus (FK 506)-based immunosuppression.1–3 Although there was no mortality in adults during the first 2 years after initiation of our Intestinal Transplantation program, survival rates worsened rapidly over the last 3 years. In this article, we analyze the main contributing factors for the deterioration of patient and graft outcome after adult Intestinal Transplantation.

  • Effect of CMV serology on outcome after clinical Intestinal Transplantation.
    Transplantation proceedings, 1996
    Co-Authors: H. Furukawa, Kareem Abu-elmagd, Jorge Reyes, Thomas E. Starzl, Shimon Kusne, Michael Green, S Todo
    Abstract:

    OVER the last 5 years, Intestinal Transplantation has become a feasible therapeutic option for patients with irreversible Intestinal failure.1 Cytomegalovirus (CMV) infection was shown to be the most frequent viral infection in the Intestinal transplant recipients and to be related to high mortality and morbidity.2,3 In this study, we analyzed the effect of CMV serology of donors and recipients on the outcome of patient and graft survival after Intestinal Transplantation.

Enrico Benedetti - One of the best experts on this subject based on the ideXlab platform.

  • living donor Intestinal Transplantation
    Gastroenterology Clinics of North America, 2018
    Co-Authors: Ivo Tzvetanov, Kiara A. Tulla, Giuseppe Damico, Enrico Benedetti
    Abstract:

    Living donor Intestinal Transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor Intestinal/liver Transplantation in pediatric recipients with Intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols. In the case of available identical twins or HLA-identical sibling, LDIT has a significant immunologic advantage and should be offered.

  • Living donor Intestinal Transplantation in pediatric recipients
    Current Opinion in Organ Transplantation, 2006
    Co-Authors: Enrico Benedetti, Giuliano Testa
    Abstract:

    The purpose of this review is to assess the role of Intestinal transplant from living donors in the treatment of pediatric patients with irreversible Intestinal failure as a potential alternative to cadaver Intestinal transplant. The use of a living donor for Intestinal Transplantation has recently been applied in the setting of pediatric candidates. The procedure has some potential advantages in comparison to cadaver Intestinal Transplantation. Of particular interest is the development of a technique for simultaneous liver/bowel transplant from living donors, because it provides an alternative treatment for a group of patients with a high risk of premature death on the cadaver waiting list. Living donor Intestinal transplant can offer considerable advantages in special settings, such as pediatric patients at high risk of premature death as a result of a lack of central venous access or highly sensitized candidates. The recent development of a technique for combined liver/bowel transplant from living donors may prove life-saving in this setting.

  • Surgical approaches and Intestinal Transplantation
    Best Practice & Research in Clinical Gastroenterology, 2003
    Co-Authors: Enrico Benedetti, Fabrizio Panaro, Mark J. Holterman, Herand Abcarian
    Abstract:

    Abstract The surgical treatment of short-bowel syndrome has been traditionally based on the correction of mechanical obstruction, which is responsible for bacterial overgrowth syndrome, or on Intestinal expansion procedures. Since the introduction of clinical Intestinal Transplantation by Lillehei in 1964, there have been remarkable advances in the immunosuppressive regimens to control rejection and in preservation techniques, monitoring and critical care. Newer and more powerful immunosuppressants have helped to transform Intestinal Transplantation into a clinical reality—Transplantation can now be a life-saving procedure for patients with Intestinal failure. It is currently indicated in the event of life-threatening complications of an underlying disease or from total parenteral nutrition (TPN). Rehabilitation in successful cases is excellent.

George V. Mazariegos - One of the best experts on this subject based on the ideXlab platform.

  • New Insights Into the Indications for Intestinal Transplantation: Consensus in the Year 2019.
    Transplantation, 2019
    Co-Authors: S. Kaufman, George V. Mazariegos, Gabriel Gondolesi, Yaron Avitzur, Sue V. Beath, Laurens Ceulemans, Loris Pironi
    Abstract:

    In 2001, a Statement was published that described indications for Intestinal Transplantation in patients with Intestinal failure expected to require parenteral nutrition indefinitely. Since 2001, advances in the management of Intestinal failure including Transplantation and patient survival, both on extended parenteral nutrition and after Transplantation, have improved, leading to a reduction in the number of Intestinal transplants worldwide from a peak of 270 per year in 2008 to 149 per year in 2017. These changes suggest that the original 2001 Statement requires reassessment. All patients with permanent Intestinal failure should be managed by dedicated multidisciplinary Intestinal rehabilitation teams. Under care of these teams, patients should be considered for Intestinal Transplantation in the event of progressive Intestinal failure-associated liver disease, progressive loss of central vein access, and repeated life-threatening central venous catheter-associated infections requiring critical care. Additional indications for Transplantation include large desmoid tumors and other intra-abdominal tumors with reasonable expectation of posttransplant cure, extensive mesenteric vein thrombosis and Intestinal infarction, total Intestinal aganglionosis, and nonrecoverable congenital secretory diarrhea. Quality of life typically improves after successful Intestinal Transplantation and may support the decision to proceed with Transplantation when other indications are present. However, the requirement for life-long immunosuppression and its associated side effects preclude Intestinal Transplantation if motivated only by an expectation of improved quality of life. Increasing experience with Intestinal Transplantation and critical appraisal of transplant outcomes including graft survival and patient quality of life together with potential advances in immunosuppression can be expected to influence transplant practices in the future.

  • Pediatric Intestinal Transplantation
    Gastroenterology Clinics of North America, 2018
    Co-Authors: Neslihan Celik, Rakesh Sindhi, Kyle Soltys, Geoffrey J. Bond, George V. Mazariegos, Jeffrey A. Rudolph, Armando Ganoza
    Abstract:

    Pediatric Intestinal Transplantation has moved from the theoretic to an actual therapy for children with irreversible Intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of Intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved Intestinal adaptation, the indications for Intestinal Transplantation are evolving. Long-term outcomes have improved, but challenges in long-term graft function owing to chronic rejection and immunosuppressant-related complications remain the major opportunities for improvement.

  • Pediatric Intestinal Transplantation
    Seminars in Pediatric Surgery, 2017
    Co-Authors: Kyle Soltys, Rakesh Sindhi, Armando Ganoza, Geoff Bond, Sara K. Rassmussen, Ajai Khanna, George V. Mazariegos
    Abstract:

    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.

  • Intestinal Transplantation in Children
    Pediatric Drugs, 2011
    Co-Authors: Navdeep Nayyar, William Mcghee, D Martin, Rakesh Sindhi, Kyle Soltys, Geoffrey J. Bond, George V. Mazariegos
    Abstract:

    This review summarizes the outcomes and known adverse effects of current immunosuppression strategies in use in pediatric Intestinal Transplantation. Intestinal Transplantation has evolved from an experimental therapy to a highly successful treatment for children with Intestinal failure who have complications with total parenteral nutrition. Because of continued success with Intestinal Transplantation over the past decade, the focus of clinicians and researchers is shifting from short-term patient survival to optimizing long-term outcomes.

  • Intestinal Transplantation in Children
    Pediatric Drugs, 2011
    Co-Authors: Navdeep Nayyar, William Mcghee, D Martin, Rakesh Sindhi, Kyle Soltys, Geoffrey Bond, George V. Mazariegos
    Abstract:

    This review summarizes the outcomes and known adverse effects of current immunosuppression strategies in use in pediatric Intestinal Transplantation. Intestinal Transplantation has evolved from an experimental therapy to a highly successful treatment for children with Intestinal failure who have complications with total parenteral nutrition. Because of continued success with Intestinal Transplantation over the past decade, the focus of clinicians and researchers is shifting from short-term patient survival to optimizing long-term outcomes. Current 5-year patient and graft survival rates after Intestinal Transplantation are 58% and 40%, respectively, in the US; single centers have reported nearly 80% patient and 60% graft survival rates at 5 years. The immunosuppression strategy in Intestinal Transplantation includes a tacrolimus-based regimen, usually in conjunction with an antibody induction therapy such as rabbit-antithymocyte globulin, interleukin-2 receptor antagonists, or alemtuzumab. The use of these immunosuppressive regimens, along with improved medical and surgical care, has contributed significantly toward improved outcomes. Optimization of post-transplant immunosuppression strategies to reduce adverse effects while minimizing acute and chronic graft rejection is a strong clinical and research focus.

Related terms

Intestinal Transplantation - 15 days free trial to Access Experts & Abstracts