Weaning Off Prognosis Factors of Home Parenteral Nutrition for Children With Primary Digestive Disease

Petit, Laëtitia Marie; Girard, Delphine; Ganousse-Mazeron, Solene; Talbotec, Cécile; Pigneur, Bénédicte; Elie, Caroline; Corriol, Odile; Poisson, Catherine; Goulet, Olivier; Colomb, V.

doi:10.1097/mpg.0000000000000980

Cited by 29 publications

(24 citation statements)

References 34 publications

(48 reference statements)

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“…The improvement in IF care observed in our unit with a low mortality of children on long‐term PN spread in Europe from the 2000s with the development of IF networks, explaining the absence of non‐French‐resident children in our recent candidates . In retrospect, the sickest patients with lowest odds of survival should not have been transplanted.…”

Section: Discussionmentioning

confidence: 86%

“…The first graft was a SBTx ( n = 9) or a L‐SBTx ( n = 1), implanted at a median age of 5 years , and removed a median of 26 months later [1–105], for CMV ( n = 2), chronic ( n = 4), or acute rejection ( n = 4). The second procedure was SBTx in three patients and L‐SBTx in seven patients, at a median age of 12.7 years . Immunosuppression included induction in all of them, basiliximab in six, and antithymocyte globulins in the four more recent ones.…”

Section: Resultsmentioning

confidence: 99%

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Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center

Lacaille¹,

Irtan²,

Dupic³

et al. 2017

Transpl Int

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Our aim was to describe our achievements in pediatric intestinal transplantation (ITx) and define areas for improvement. After a period (1987-1990) of nine isolated small bowel transplants (SBTx) where only one patient survived with her graft, 110 ITx were performed on 101 children from 1994 to 2014: 60 SBTx, 45 liver-small bowel, four multivisceral (three with kidneys), and one modified multivisceral. Indications were short bowel syndrome (36), motility disorders (30), congenital enteropathies (34), and others (1). Induction treatment was introduced in 2000. Patient/graft survival with a liver-containing graft or SBTx was, respectively, 60/41% and 46/11% at 18 years. Recently, graft survival at 5/10 years was 44% and 31% for liver-containing graft and 57% and 44% for SBTx. Late graft loss occurred in 13 patients, and 7 of 10 retransplanted patients died. The main causes of death and graft loss were sepsis and rejection. Among the 55 currently living patients, 21 had a liver-containing graft, 19 a SBTx (17 after induction), and 15 were on parenteral nutrition. ITx remains a difficult procedure, and retransplantation even more so. Over the long term, graft loss was due to rejection, over-immunosuppression was not a significant problem. Multicenter studies on immunosuppression and microbiota are urgently needed.

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Section: Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center

Lacaille¹,

Irtan²,

Dupic³

et al. 2017

Transpl Int

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“…Our patients with congenital intestinopathy were quite young, and thus long‐term prognosis for these patients remains unclear. However, most tolerated some enteral feeds, reducing the risk for IFALD, and CRBSI rates were low. Specific genotypes for PIMDs are identified increasingly .…”

Section: Discussionmentioning

confidence: 99%

“…The non‐SBS causes for pediatric IF include primary intestinal motility disorders (PIMDs) and various congenital intestinopathies. The likelihood of weaning off PN remains lower in these patient groups, necessitating expert long‐term care to ensure adequate nutrition, while minimizing liver derangements and central venous catheter (CVC)‐associated hazards . Eventually few patients with IF will require intestinal transplantation (ITx), offering a chance to survive when life‐threatening complications prevent safe continuation of PN.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Intestinal Failure: The Key Outcomes for the First 100 Patients Treated in a National Tertiary Referral Center During 1984–2017

Merras‐Salmio

Mutanen

Ylinen

et al. 2018

J Parenter Enteral Nutr

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“…In our series, children with preserved ICV or colon had a significantly greater probability of favourable outcome, while the influence of the remaining intestine length failed to reach significance, probably due to small numbers [38]. …”

Section: Discussionmentioning

confidence: 99%

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Stýblová¹,

Kalousová

Adamcová³

et al. 2017

Ann Nutr Metab

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Background: Treatment quality and outcomes of paediatric home parenteral nutrition (HPN) program during its development in the Czech Republic. Methods: A retrospective study of patients receiving HPN from May 1995 till June 2011. Results: Sixty-six patients were treated in 8 centres. In 48 patients, long-term PN began in the first year of life and in 35 of them in the first month. Sixty children had gastrointestinal and 6 had non-gastrointestinal disease. In a majority of the patients, the Broviac catheter was used. Thirty-two (48.5%) patients were weaned from PN after 1-117 months, 21 (32.8%) continued on HPN after 7-183 months, and 13 (19.7%) patients died, all on PN. The mortality in patients with primary gastrointestinal disease was significantly lower than in patients with non-gastrointestinal disease. Thirty-one paediatric patients were receiving HPN for 14,480 catheter days in 2009-2010. Fourteen patients had 23 Catheter Related Blood Stream Infections (CRBSI) episodes. The incidence of CRBSI in 2009-2010 was 1.58/1,000 catheter days. Conclusion: Submitted data showed that even in the absence of expert centres, patient care may achieve results comparable to countries with well-developed HPN program. A majority of Czech HPN patients are at present treated in specialized centres, following the most desirable pattern of care.

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Weaning Off Prognosis Factors of Home Parenteral Nutrition for Children With Primary Digestive Disease

Cited by 29 publications

References 34 publications

Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center

Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center

Pediatric Intestinal Failure: The Key Outcomes for the First 100 Patients Treated in a National Tertiary Referral Center During 1984–2017

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

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