Assessment of function, growth and development, and long-term quality of life after small bowel transplantation

Sudan, Debra; Iverson, Angie; Weseman, Rebecca A.; Kaufman, Stuart S.; Horslen, Simon; Fox, Ira J.; Shaw, Byers W.; Langnas, Alan Norman

doi:10.1016/s0041-1345(00)01190-8

Cited by 60 publications

(26 citation statements)

References 1 publication

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“…One published evaluation of SBTx found that most children were able to return to age-appropriate activities following SBTx, although some required additional educational and developmental services in order to achieve this (27). A study of adults who had received a SBTx found that most experienced a significant improvement in health-related quality of life, including reduced depression and anxiety, and increased physical and social functioning (28).…”

Section: Discussionmentioning

confidence: 99%

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An Economic Evaluation of Pediatric Small Bowel Transplantation in the United Kingdom

Longworth¹,

Young²,

Beath

et al. 2006

Transplantation

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Firm conclusions on cost-effectiveness of SBTx are not possible given the two different estimates. The prognostic model approach (suggesting that pediatric SBTx may provide a small survival benefit at a small reduction in costs) should be less subject to bias, but the model requires external validation. Meanwhile, children at risk of fatal PN-complications should be given the opportunity to receive a SBTx only within a continuing formal assessment of the technology.

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Section: Discussionmentioning

confidence: 99%

“…Routine longer-term follow-up is now available, but only for the patients who were transplanted. Of the 14 patients who received a SBTx, five (36%) were alive at 27 …”

Section: Discussionmentioning

confidence: 99%

An Economic Evaluation of Pediatric Small Bowel Transplantation in the United Kingdom

Longworth¹,

Young²,

Beath

et al. 2006

Transplantation

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“…However, a mean of seven daily medications is still required at >3 years posttransplantation, and 17% of patients continue to require enteral feeding due to oral aversion [171]. More than 80% of patients who are school aged are attending school full-time at 3 years posttransplantation [163]or have returned to school at the appropriate level [172].…”

Section: Quality Of Life In Small Bowel Transplantmentioning

confidence: 99%

Short Bowel Syndrome: Parenteral Nutrition Versus Intestinal Transplantation. Where Are We Today?

et al. 2007

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Current management of short bowel syndrome (SBS) revolves around the use of home TPN (HPN). Complications include liver disease, catheter-related infections or occlusions, venous thrombosis, and bone disease. Patient survival with SBS on TPN is 86% and 75% at 2 and 5 years, respectively. Surgical management of SBS includes nontransplant surgeries such as serial transverse enteroplasty and reanastomosis. Small bowel transplant has become increasingly popular for management of SBS and is usually indicated when TPN cannot be continued. Posttransplant complications include graft-versus-host reaction, infections in an immunocompromised patient, vascular and biliary diseases, and recurrence of the original disease. Following intestinal-only transplants, patient and graft survival rate is 77% and 66% after 1 year. After 5 years the survival figures are 49% and 34%, respectively. Future improvements in survival and quality of life will enhance small bowel transplant as a viable treatment option for patients with SBS.

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“…Mortality is not of course the only issue. The recent emphasis on quality of life [14] and long-term graft function [15] is most appropriate, as the final judgment on the relative risks and benefits of HPN versus transplantation must take all of these factors into account.…”

Section: Indications and Patient Selectionmentioning

confidence: 99%

Small intestinal transplantation

Quigley

2001

Curr Gastroenterol Rep

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The past few years have witnessed a considerable shift in the clinical status of intestinal transplantation. A great deal of experience has been gained at the most active centers, and results comparable with those reported at a similar stage in the development of other solid-organ graft programs are now being achieved by these highly proficient transplant teams. Rejection and its inevitable associate, sepsis, remain ubiquitous, and new immunosuppressant regimes are urgently needed; some may already be on the near horizon. The recent success of isolated intestinal grafts, together with the mortality and morbidity attendant upon the development of advanced liver disease related to total parenteral nutrition, has prompted the bold proposal that patients at risk for this complication should be identified and should receive isolated small bowel grafts before the onset of end-stage hepatic failure. The very fact that such a suggestion has begun to emerge reflects real progress in this challenging field.

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Assessment of function, growth and development, and long-term quality of life after small bowel transplantation

Cited by 60 publications

References 1 publication

An Economic Evaluation of Pediatric Small Bowel Transplantation in the United Kingdom

An Economic Evaluation of Pediatric Small Bowel Transplantation in the United Kingdom

Short Bowel Syndrome: Parenteral Nutrition Versus Intestinal Transplantation. Where Are We Today?

Small intestinal transplantation

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