Improved quality of life by combined transplantation in Hirschsprung's disease with a very long aganglionic segment

Revillon Yann, Aigrain Yves, Jan Dominique, Yandza Thierry, Goulet Olivier, Lacaille Florence, M. Ziegler, M. Schwartz

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background/Purpose: The treatment of children with Hirschsprung's disease beginning in the proximal jejunum remains a challenge for the pediatric surgeon. These patients need a definitive parenteral nutrition, which could lead to a liver impairment. The goal of this work is to assess the quality of life after combined liver, intestine, and right colon transplantation. Methods: This is a retrospective study of 3 patients. Data regarding symptomatology, radiographic and operating findings, postoperating recovery, and quality of life were analyzed and compared with the quality of life before the transplantation. Results: The suspicion of a very long intestinal aganglionosis should be derived from the intestinal biopsies. Three combined liver, intestine, and right colon transplantation operations have been performed. The immunosuppression included steroids, tacrolimus, and azathioprine. An abdominal pull-trough (Duhamel procedure 2, Swenson procedure 1) was performed from 6 to 24 months after the transplantation. The follow-up after the transplantation ranges from 2 to 6 years. These 3 patients are completely off total parenteral nutrition with bowel movements 2 to 3 times a day. Two patients are continent day and night, and one is continent during the day only. Conclusions: Intestinal transplantation is feasible with good results even when a liver impairment needs a combined intestine and liver transplantation. The right colon transplantation, in our experience, does not impair the results. The quality of life after the transplantation is better than before.

Original languageEnglish (US)
Pages (from-to)422-424
Number of pages3
JournalJournal of Pediatric Surgery
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

Keywords

  • Hirschsprung's disease
  • Intestinal transplantation
  • Liver failure
  • Liver transplantation
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Improved quality of life by combined transplantation in Hirschsprung's disease with a very long aganglionic segment'. Together they form a unique fingerprint.

  • Cite this