| Title: |
Addressing extreme size mismatch in pediatric intestinal transplantation: Outcomes of intestinal length reduction |
| Authors: |
Hann, Angus; Gupte, Girish L.; Pathanki, Adithya; Coelho, Maria; Beath, Sue; Hartley, Jane; Kelly, Deirdre; De Ville De Goyet, Jean; Oo, Ye H.; Hartog, Hermien; Perera, Thamara P. R.; Sharif, Khalid; Mirza, Darius F. |
| Source: |
Pediatric Transplantation ; volume 27, issue 5 ; ISSN 1397-3142 1399-3046 |
| Publisher Information: |
Wiley |
| Publication Year: |
2023 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Background Bench liver reduction, with or without intestinal length reduction (LR) (coupled with delayed closure and abdominal wall prostheses), has been a strategy adopted by our program for small children due to the limited availability of size‐matched donors. This report describes the short, medium, and long‐term outcomes of this graft reduction strategy. Methods A single‐center, retrospective analysis of children that underwent intestinal transplantation (April 1993 to December 2020) was performed. Patients were grouped according to whether they received an intestinal graft of full length (FL) or following LR. Results Overall, 105 intestinal transplants were performed. The LR group ( n = 10) was younger (14.5 months vs. 40.0 months, p = .012) and smaller (8.7 kg vs. 13.0 kg, p = .032) compared to the FL group ( n = 95). Similar abdominal closure rates were achieved after LR, without any increase in abdominal compartment syndrome (1/10 vs. 7/95, p = .806). The 90‐day graft and patient survival were similar (9/10, 90% vs. 83/95, 86%; p = .810). Medium and long‐term graft survival at 1 year (8/10, 80% vs. 65/90, 71%; p = .599), and 5 years (5/10, 50% vs. 42/84, 50%; p = 1.00) was similar. Conclusion LR of intestinal grafts appears to be a safe strategy for infants and small children requiring intestinal transplantation. This technique should be considered in the situation of significant size mismatch of intestine containing grafts. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/petr.14528 |
| Availability: |
https://doi.org/10.1111/petr.14528; https://onlinelibrary.wiley.com/doi/pdf/10.1111/petr.14528 |
| Rights: |
http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.F2987B85 |
| Database: |
BASE |