This page contains exclusive content for the member of the following sections: TTS, ITA. Log in to view.
Presenter: Sara, Gozzini, Birmingham, United Kingdom
Authors: Sara Gozzini1, Khalid Sharif1, Paolo Muiesan2, Sue Beath1, Jane Hartley1, Girish Gupte1, Darius Mirza2
Sara Gozzini1, Khalid Sharif1, Paolo Muiesan2, Sue Beath1, Jane Hartley1, Girish Gupte1, Darius Mirza2
1Liver Unit, Birmingham Children's Hospital, Birmingham, United Kingdom; 2Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
Background: Following pediatric intestinal transplant (ITx) ileostomy is performed to monitor for rejection. Once the risk decreases, reconnection surgery (RS) can be considered as an option to improve quality of life, although it abolishes an easy way of graft surveillance. The aim was to study criteria influencing graft reconnection.
Material and Methods: Retrsospective review of 77 paediatric ITx and 34 (data available in 30) transplanted for short gut syndrome and eligible for RS were included. Group 1 (stoma closed) and group 2 (stoma opened) were identified, analyzing recipient data, trend of rejection, complications, survival and outcome.
Results:
|
Group 1 N=10 |
Group 2 N=20 |
P-value |
Median Length of bowel left |
30 cm |
20 cm |
0.177 |
Age at ITx |
5.2 yr |
1.5 yr |
0.031 |
Weight at ITx |
19.5 kg |
9.4 kg |
0.008 |
Onset of early rejection |
8 |
11 |
0.051 |
number of rejections |
10 |
20 |
0.12 |
Median grade of rejection (1-4 score) |
3.5 |
3.0 |
0.524 |
Median length of time from ITx to RS |
20 months (10-43) |
|
|
Median rime from last episode of rejection to RS |
13 months (6-30) |
|
|
Overall survival |
90% |
50% |
0.032 |
Conclusion: Onset, number and grade of rejection, may be not considered as excluding criteria to reconnect a graft. Patients with relatively uneventful post operative period are better candidates for RS. From our little experience, we would recommend a 1 year wait from the last episode of rejection before RS
By viewing the material on this site you understand and accept that:
The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada