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Text
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<a href="http://doi.org/10.1542/peds.2009-1713" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2009-1713</a>
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Title
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Outcomes in children after intestinal transplant
Publisher
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Pediatrics
Date
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2010
Subject
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Child; Female; Humans; Male; Survival Rate; Treatment Outcome; Preschool; infant; retrospective studies; Intestines/transplantation; Intestinal Diseases/surgery
Creator
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Lao OB; Healey PJ; Perkins JD; Horslen S; Reyes JD; Goldin AB
Description
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OBJECTIVE: The survival rates after pediatric intestinal transplant according to underlying disease are unknown. The objective of our study was to describe the population of pediatric patients receiving an intestinal transplant and to evaluate survival according to specific disease condition. PATIENTS: Pediatric patients (< or =21 years of age) with intestinal failure meeting criteria for intestinal transplant were included in the study. METHODS: A retrospective review of the United Network for Organ Sharing intestinal transplant database (January 1, 1991, to May 16, 2008), including all pediatric transplant centers participating in the United Network for Organ Sharing, was conducted. The main outcome measures were survival and mortality. RESULTS: Eight hundred fifty-two children received an intestinal transplant (54% male). Median age and weight at the time of transplant were 1 year (interquartile rage: 1-5) and 10.7 kg (interquartile rage: 7.8-21.7). Sixty-nine percent of patients also received a simultaneous liver transplant. The most common diagnoses among patients who received a transplant were gastroschisis (24%), necrotizing enterocolitis (15%), volvulus (14%), other causes of short-gut syndrome (19%), functional bowel syndrome (16%), and Hirschsprung disease (7%). The Kaplan-Meier curves demonstrated variation in patient survival according to diagnosis. Cox regression analysis confirmed a survival difference according to diagnosis (P < .001) and demonstrated a survival advantage for those patients listed with a diagnosis of volvulus (P < .01) compared with the reference gastroschisis. After adjusting for gender, recipient weight, and concomitant liver transplant, children with volvulus had a lower hazard ratio for survival and a lower risk of mortality. CONCLUSIONS: Survival after intestinal transplant was associated with the underlying disease state. The explanation for these findings requires additional investigation into the differences in characteristics of the population of children with intestinal failure.
2010
Identifier
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<a href="http://doi.org/10.1542/peds.2009-1713" target="_blank" rel="noreferrer">10.1542/peds.2009-1713</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2010
Backlog
Child
Female
Goldin AB
Healey PJ
Horslen S
Humans
Infant
Intestinal Diseases/surgery
Intestines/transplantation
Journal Article
Lao OB
Male
Pediatrics
Perkins JD
Preschool
Retrospective Studies
Reyes JD
Survival Rate
Treatment Outcome