Outcomes in children after intestinal transplant

Title

Outcomes in children after intestinal transplant

Creator

Lao OB; Healey PJ; Perkins JD; Horslen S; Reyes JD; Goldin AB

Publisher

Pediatrics

Date

2010

Subject

Child; Female; Humans; Male; Survival Rate; Treatment Outcome; Preschool; infant; retrospective studies; Intestines/transplantation; Intestinal Diseases/surgery

Description

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

Rights

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

Journal Article

Citation List Month

Backlog

Pages

e550-8

Issue

3

Volume

125

Citation

Lao OB; Healey PJ; Perkins JD; Horslen S; Reyes JD; Goldin AB, “Outcomes in children after intestinal transplant,” Pediatric Palliative Care Library, accessed May 16, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13961.

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