Quality of life in adults following small bowel transplantation

Cameron, Ewen; Binnie, James; Jamieson, Neville V.; Pollard, S.; Middleton, Stephen

doi:10.1016/s0041-1345(02)02719-7

Cited by 48 publications

(29 citation statements)

References 7 publications

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“…Cameron et al using the generic instrument Short Form 36 (SF-36) to compare four patients after ITx with 12 stable patients on HPN failed to reveal differences between the groups (10). Similarly, using the SF 36 questionnaire we compared 18 patients stable on HPN and 12 patients who underwent successful ITx, observing that only the body pain score differed significantly between the groups, with a better value in ITx recipients (11).…”

Section: Discussionmentioning

confidence: 93%

“…Studies have shown that adult patients receiving HPN for benign IF have a poorer QoL than that of the normal population and of some patients with chronic illness (5,6). The few studies that compared the health-related QoL of patients on HPN with that of adult ITx recipients showed a modest improvement of QoL posttransplant (7)(8)(9)(10)(11). In these studies, the instruments used to assess QoL were generic health status questionnaires (10,11) and a treatment-specific tool designed for transplant recipients (8,9).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

Pironi

Baxter²,

Lauro

et al. 2012

American Journal of Transplantation

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In order to investigate the quality of life on home parenteral nutrition and after intestinal transplantation using comparable questionnaires, the treatmentspecific quality of life questionnaire for adult patients on home parenteral nutrition was adapted for intestinal transplant recipients. Both instruments were composed of 8 functional scales, 9 symptom scales, 3 global health status/quality of life scales and 2 single items. A preliminary cross-sectional study enrolling all the patients currently cared at the same hospital was carried out. Exclusion criteria were age ≥ 60 years and hospitalization at time of assessment. Thirty-three home parenteral nutrition patients (100% answered) and 22 intestinal transplant recipients (82% answered) were enrolled. Intestinal transplant recipients showed a better score in following scales: ability to holiday/travel (p < 0.001), fatigue (p = 0.022), gastrointestinal symptoms (p < 0.001), stoma management/bowel movements (p = 0.001) and global health status/quality of life (p = 0.012). A better score for ability to eat/drink (p = 0.070) and a worse score for sleep pattern (p = 0.100) after intestinal transplantation were also observed. The results of this preliminary study with specific instruments were consistent with the main expected improvement of the quality of life related to intestinal transplantation. Further studies in larger patient cohorts are required to confirm these data.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

Pironi

Baxter²,

Lauro

et al. 2012

American Journal of Transplantation

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“…Adult patients after intestinal transplantation report a similar or in some cases better quality of life compared with patients dependent on TPN (13,23). We are currently examining a group of children on TPN to determine if this holds true, but these results…”

Section: Discussionmentioning

confidence: 99%

Quality of Life after Pediatric Intestinal Transplantation: The Perception of Pediatric Recipients and Their Parents

Sudan¹,

Horslen

Botha

et al. 2004

American Journal of Transplantation

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The objective was to examine the perception of physical and psychosocial functioning of pediatric intestinal transplant recipients who are beyond the perioperative period and compare these with normal and chronically ill children.Child and parent forms of the Child Health Questionnaire were administered to all 29 pediatric intestinal transplant recipients between the ages of 5 and 18 years who had had a small bowel transplantation 1 year previous and had a functional allograft. Comparison was made with published norms and scores for pediatric patients on hemodialysis.Intestinal transplant recipients (on average 5 years after intestinal transplantation and at a mean age 11 years) reported similar scores in all domains compared with normal children. Parents of intestinal transplant recipients noted decreased function in several domains related to their child's general health, physical functioning, and the impact of the illness on parental time, emotions and family activities.Intestinal transplant recipients beyond the perioperative period perceive their physical and psychosocial functioning as similar to normal school children. Parental proxy assessments differ from the recipients, with the parent's perception of decreased general health and physical functioning for intestinal transplant recipients compared with norms.

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“…6,117 Equally important, is the significant improvement in the quality of life due to elimination of the undesirable effects of both CD and HPN therapy on most of the socioeconomic milestones and quality of life health-related domains. 40,42,45,74,[124][125][126][127] It is reasonable to believe that full restoration of the quality of life after transplantation is largely determined by the duration and severity of CD as well as the extent of the HPN associated complications before transplantation. 40,45,125,126 Accordingly, early gut rehabilitation including transplantation should be considered before the development of overt and subtle irreversible damage to the patient body organs including the central nervous system.…”

Section: Survival Outcomementioning

confidence: 99%

Management of Crohnʼs Disease in the New Era of Gut Rehabilitation and Intestinal Transplantation

Nyabanga

Kochhar

Costa

et al. 2016

Inflammatory Bowel Diseases

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Despite recent therapeutic advances, patients with Crohn's disease (CD) continue to experience high recurrence with cumulative structural damage and ultimate loss of nutritional autonomy. With short bowel syndrome, strictures, and enteric fistulae being the underlying pathology, CD is the second common indication for home parenteral nutrition (HPN). With development of intestinal failure, nutritional management including HPN is required as a rescue therapy. Unfortunately, some patients do not escape the HPN-associated complications. Therefore, the concept of gut rehabilitation has evolved as part of the algorithmic management of these patients, with transplantation being the ultimate life-saving therapy. With type 2 intestinal failure, comprehensive rehabilitative measures including nutritional care, pharmacologic manipulation, autologous reconstruction, and bowel lengthening is often successful, particularly in patients with quiescent disease. With type 3 intestinal failure, transplantation is the only life-saving treatment for patients with HPN failure and intractable disease. With CD being the second common indication for transplantation in adults, survival outcome continues to improve because of surgical innovation, novel immunosuppression, and better postoperative care. Despite being a rescue therapy, the procedure has achieved survival rates similar to other solid organs, and comparable to those who continue to receive HPN therapy. With similar technical, immunologic, and infectious complications, survival is similar in the CD and non-CD recipients. Full nutritional autonomy is achievable in most survivors with better quality of life and long-term cost-effectiveness. CD recurrence is rare with no impact on graft function. Further progress is anticipated with new insights into the pathogenesis of CD and mechanisms of transplant tolerance.

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Quality of life in adults following small bowel transplantation

Cited by 48 publications

References 7 publications

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

Quality of Life after Pediatric Intestinal Transplantation: The Perception of Pediatric Recipients and Their Parents

Management of Crohnʼs Disease in the New Era of Gut Rehabilitation and Intestinal Transplantation

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