Factors Influencing Outcome After Intestinal Transplantation in Children

F. Sauvat, L. Dupic, D. Caldari, F. Lesage, J. P. Cezard, F. Lacaille, F. Ruemmele, J. P. Hugot, V. Colomb, Dominique M. Jan, P. Hubert, Y. Revillon, O. Goulet

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

We evaluated 131 patients (6 months-14 years) who experienced 21 deaths before listing, 11 continuing on the waiting list, 38 well on home parenteral nutrition, 6 off parenteral nutrition and 59 transplanted (20 girls) aged 2.5 to 15 years, (18 >7 years). They received cadaveric isolated intestine (ITx, n = 31) or liver-small bowel (LITx, n = 32), including right colon (n = 43; 23 LITx) for short bowel (n = 19), enteropathy (n = 20), Hirschsprung (n = 14), or pseudo-obstruction (n = 6). Treatment included tacrolimus, steroids, azathioprine, or interleukin-2 blockers. After 6 months to 10.5 years, the patient and graft survivals were 75% and 54%. Sixteen patients (10 LITx) died within 3 months from surgery (n = 3), bacterial (n = 5) or fungal (n = 6) sepsis, or posttransplant lymphoproliferative disorder (n = 2). Rejection occurred in 27 patients, including 10 steroid-resistant episodes requiring antilymphoglobulins. The grafts were removed due to uncontrolled rejection in seven ITx recipients. Surgical complications were observed in 38 recipients (25 LSBTx) within 2 months, including bacterial (n = 22) or fungal (n = 11) sepsis, cytomegalovirus disease (n = 12), adenovirus (n = 11), or posttransplant lymphoproliferative disorder (n = 12). Forty-two children (19 LSBTx) are alive. Weaning from parenteral nutrition was achieved after 42 days (median). Factors related to death or graft loss were pre-Tx surgery (P < .01), pseudo-obstruction (P < .01), age over 7 years (P < .03), fungal sepsis (P < .03), steroid resistant rejection (P < .05), hospitalized versus home patient (P < .01), and retransplantation (P < .05). Colon transplant did not affect the outcome. Interleukin-2 blockers improved isolated ITx (P < .05). Early referral and close monitoring of intestinal failure and related disorders are mandatory to achieve successful ITx.

Original languageEnglish (US)
Pages (from-to)1689-1691
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number6
DOIs
StatePublished - Jul 2006
Externally publishedYes

Fingerprint

Transplantation
Sepsis
Lymphoproliferative Disorders
Steroids
Parenteral Nutrition
Transplants
Interleukin-2
Colon
Home Parenteral Nutrition
Waiting Lists
Azathioprine
Tacrolimus
Graft Survival
Weaning
Cytomegalovirus
Adenoviridae
Intestines
Referral and Consultation
Liver
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Sauvat, F., Dupic, L., Caldari, D., Lesage, F., Cezard, J. P., Lacaille, F., ... Goulet, O. (2006). Factors Influencing Outcome After Intestinal Transplantation in Children. Transplantation Proceedings, 38(6), 1689-1691. https://doi.org/10.1016/j.transproceed.2006.05.033

Factors Influencing Outcome After Intestinal Transplantation in Children. / Sauvat, F.; Dupic, L.; Caldari, D.; Lesage, F.; Cezard, J. P.; Lacaille, F.; Ruemmele, F.; Hugot, J. P.; Colomb, V.; Jan, Dominique M.; Hubert, P.; Revillon, Y.; Goulet, O.

In: Transplantation Proceedings, Vol. 38, No. 6, 07.2006, p. 1689-1691.

Research output: Contribution to journalArticle

Sauvat, F, Dupic, L, Caldari, D, Lesage, F, Cezard, JP, Lacaille, F, Ruemmele, F, Hugot, JP, Colomb, V, Jan, DM, Hubert, P, Revillon, Y & Goulet, O 2006, 'Factors Influencing Outcome After Intestinal Transplantation in Children', Transplantation Proceedings, vol. 38, no. 6, pp. 1689-1691. https://doi.org/10.1016/j.transproceed.2006.05.033
Sauvat, F. ; Dupic, L. ; Caldari, D. ; Lesage, F. ; Cezard, J. P. ; Lacaille, F. ; Ruemmele, F. ; Hugot, J. P. ; Colomb, V. ; Jan, Dominique M. ; Hubert, P. ; Revillon, Y. ; Goulet, O. / Factors Influencing Outcome After Intestinal Transplantation in Children. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 6. pp. 1689-1691.
@article{8e9ef8b174084a53b3acd74141125347,
title = "Factors Influencing Outcome After Intestinal Transplantation in Children",
abstract = "We evaluated 131 patients (6 months-14 years) who experienced 21 deaths before listing, 11 continuing on the waiting list, 38 well on home parenteral nutrition, 6 off parenteral nutrition and 59 transplanted (20 girls) aged 2.5 to 15 years, (18 >7 years). They received cadaveric isolated intestine (ITx, n = 31) or liver-small bowel (LITx, n = 32), including right colon (n = 43; 23 LITx) for short bowel (n = 19), enteropathy (n = 20), Hirschsprung (n = 14), or pseudo-obstruction (n = 6). Treatment included tacrolimus, steroids, azathioprine, or interleukin-2 blockers. After 6 months to 10.5 years, the patient and graft survivals were 75{\%} and 54{\%}. Sixteen patients (10 LITx) died within 3 months from surgery (n = 3), bacterial (n = 5) or fungal (n = 6) sepsis, or posttransplant lymphoproliferative disorder (n = 2). Rejection occurred in 27 patients, including 10 steroid-resistant episodes requiring antilymphoglobulins. The grafts were removed due to uncontrolled rejection in seven ITx recipients. Surgical complications were observed in 38 recipients (25 LSBTx) within 2 months, including bacterial (n = 22) or fungal (n = 11) sepsis, cytomegalovirus disease (n = 12), adenovirus (n = 11), or posttransplant lymphoproliferative disorder (n = 12). Forty-two children (19 LSBTx) are alive. Weaning from parenteral nutrition was achieved after 42 days (median). Factors related to death or graft loss were pre-Tx surgery (P < .01), pseudo-obstruction (P < .01), age over 7 years (P < .03), fungal sepsis (P < .03), steroid resistant rejection (P < .05), hospitalized versus home patient (P < .01), and retransplantation (P < .05). Colon transplant did not affect the outcome. Interleukin-2 blockers improved isolated ITx (P < .05). Early referral and close monitoring of intestinal failure and related disorders are mandatory to achieve successful ITx.",
author = "F. Sauvat and L. Dupic and D. Caldari and F. Lesage and Cezard, {J. P.} and F. Lacaille and F. Ruemmele and Hugot, {J. P.} and V. Colomb and Jan, {Dominique M.} and P. Hubert and Y. Revillon and O. Goulet",
year = "2006",
month = "7",
doi = "10.1016/j.transproceed.2006.05.033",
language = "English (US)",
volume = "38",
pages = "1689--1691",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Factors Influencing Outcome After Intestinal Transplantation in Children

AU - Sauvat, F.

AU - Dupic, L.

AU - Caldari, D.

AU - Lesage, F.

AU - Cezard, J. P.

AU - Lacaille, F.

AU - Ruemmele, F.

AU - Hugot, J. P.

AU - Colomb, V.

AU - Jan, Dominique M.

AU - Hubert, P.

AU - Revillon, Y.

AU - Goulet, O.

PY - 2006/7

Y1 - 2006/7

N2 - We evaluated 131 patients (6 months-14 years) who experienced 21 deaths before listing, 11 continuing on the waiting list, 38 well on home parenteral nutrition, 6 off parenteral nutrition and 59 transplanted (20 girls) aged 2.5 to 15 years, (18 >7 years). They received cadaveric isolated intestine (ITx, n = 31) or liver-small bowel (LITx, n = 32), including right colon (n = 43; 23 LITx) for short bowel (n = 19), enteropathy (n = 20), Hirschsprung (n = 14), or pseudo-obstruction (n = 6). Treatment included tacrolimus, steroids, azathioprine, or interleukin-2 blockers. After 6 months to 10.5 years, the patient and graft survivals were 75% and 54%. Sixteen patients (10 LITx) died within 3 months from surgery (n = 3), bacterial (n = 5) or fungal (n = 6) sepsis, or posttransplant lymphoproliferative disorder (n = 2). Rejection occurred in 27 patients, including 10 steroid-resistant episodes requiring antilymphoglobulins. The grafts were removed due to uncontrolled rejection in seven ITx recipients. Surgical complications were observed in 38 recipients (25 LSBTx) within 2 months, including bacterial (n = 22) or fungal (n = 11) sepsis, cytomegalovirus disease (n = 12), adenovirus (n = 11), or posttransplant lymphoproliferative disorder (n = 12). Forty-two children (19 LSBTx) are alive. Weaning from parenteral nutrition was achieved after 42 days (median). Factors related to death or graft loss were pre-Tx surgery (P < .01), pseudo-obstruction (P < .01), age over 7 years (P < .03), fungal sepsis (P < .03), steroid resistant rejection (P < .05), hospitalized versus home patient (P < .01), and retransplantation (P < .05). Colon transplant did not affect the outcome. Interleukin-2 blockers improved isolated ITx (P < .05). Early referral and close monitoring of intestinal failure and related disorders are mandatory to achieve successful ITx.

AB - We evaluated 131 patients (6 months-14 years) who experienced 21 deaths before listing, 11 continuing on the waiting list, 38 well on home parenteral nutrition, 6 off parenteral nutrition and 59 transplanted (20 girls) aged 2.5 to 15 years, (18 >7 years). They received cadaveric isolated intestine (ITx, n = 31) or liver-small bowel (LITx, n = 32), including right colon (n = 43; 23 LITx) for short bowel (n = 19), enteropathy (n = 20), Hirschsprung (n = 14), or pseudo-obstruction (n = 6). Treatment included tacrolimus, steroids, azathioprine, or interleukin-2 blockers. After 6 months to 10.5 years, the patient and graft survivals were 75% and 54%. Sixteen patients (10 LITx) died within 3 months from surgery (n = 3), bacterial (n = 5) or fungal (n = 6) sepsis, or posttransplant lymphoproliferative disorder (n = 2). Rejection occurred in 27 patients, including 10 steroid-resistant episodes requiring antilymphoglobulins. The grafts were removed due to uncontrolled rejection in seven ITx recipients. Surgical complications were observed in 38 recipients (25 LSBTx) within 2 months, including bacterial (n = 22) or fungal (n = 11) sepsis, cytomegalovirus disease (n = 12), adenovirus (n = 11), or posttransplant lymphoproliferative disorder (n = 12). Forty-two children (19 LSBTx) are alive. Weaning from parenteral nutrition was achieved after 42 days (median). Factors related to death or graft loss were pre-Tx surgery (P < .01), pseudo-obstruction (P < .01), age over 7 years (P < .03), fungal sepsis (P < .03), steroid resistant rejection (P < .05), hospitalized versus home patient (P < .01), and retransplantation (P < .05). Colon transplant did not affect the outcome. Interleukin-2 blockers improved isolated ITx (P < .05). Early referral and close monitoring of intestinal failure and related disorders are mandatory to achieve successful ITx.

UR - http://www.scopus.com/inward/record.url?scp=33746894729&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33746894729&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2006.05.033

DO - 10.1016/j.transproceed.2006.05.033

M3 - Article

VL - 38

SP - 1689

EP - 1691

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 6

ER -