Tags

Type your tag names separated by a space and hit enter

Short bowel syndrome and intestinal transplantation in children.
Curr Opin Clin Nutr Metab Care. 2006 May; 9(3):304-13.CO

Abstract

PURPOSE OF REVIEW

This review summarizes recent knowledge and clinical practice for pediatric patients suffering extensive intestinal resection causing short bowel syndrome. This condition requires the use of parenteral nutrition, as long as intestinal failure persists, and may be, in some selected cases, an indication for intestinal transplantation.

RECENT FINDINGS

Biological evaluation of intestinal failure is becoming possible with the use of plasma citrulline as a marker of intestinal mass. Few epidemiological data are available; some indicate an increased incidence of short bowel syndrome-related gastroschisis and persistent high incidence of necrotizing enterocolitis. Morbidity and mortality data in pediatric patients with short bowel syndrome are limited, while long-term outcome is better documented from recently reported cohorts. Non-transplant surgery is one of the best options for patients with unadapted short bowel syndrome. Isolated liver transplantation may be avoided. The use of trophic factors for enhancing mucosal hyperplasia still remains disappointing.

SUMMARY

The management should include therapies adapted to each stage of intestinal failure, based on a multidisciplinary approach in centers involving pediatric surgery, pediatric gastroenterology, parenteral nutrition expertise, home-parenteral nutrition program, and liver-intestinal transplantation experience. If managed appropriately, the prognosis of short bowel syndrome is excellent, with limited indications for intestinal and/or liver transplantation. Timing for patient referral in specialized centers remains an issue.

Authors+Show Affiliations

Integrated Program of Intestinal Failure, Home Parenteral Nutrition, and Intestinal Transplantation, National Reference Center for Rare Digestive Diseases, Necker Hospital for Sick Children, University of Paris, France. olivier.goulet@nck.aphp.frNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16607133

Citation

Goulet, Olivier, and Frédérique Sauvat. "Short Bowel Syndrome and Intestinal Transplantation in Children." Current Opinion in Clinical Nutrition and Metabolic Care, vol. 9, no. 3, 2006, pp. 304-13.
Goulet O, Sauvat F. Short bowel syndrome and intestinal transplantation in children. Curr Opin Clin Nutr Metab Care. 2006;9(3):304-13.
Goulet, O., & Sauvat, F. (2006). Short bowel syndrome and intestinal transplantation in children. Current Opinion in Clinical Nutrition and Metabolic Care, 9(3), 304-13.
Goulet O, Sauvat F. Short Bowel Syndrome and Intestinal Transplantation in Children. Curr Opin Clin Nutr Metab Care. 2006;9(3):304-13. PubMed PMID: 16607133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short bowel syndrome and intestinal transplantation in children. AU - Goulet,Olivier, AU - Sauvat,Frédérique, PY - 2006/4/12/pubmed PY - 2006/10/3/medline PY - 2006/4/12/entrez SP - 304 EP - 13 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 9 IS - 3 N2 - PURPOSE OF REVIEW: This review summarizes recent knowledge and clinical practice for pediatric patients suffering extensive intestinal resection causing short bowel syndrome. This condition requires the use of parenteral nutrition, as long as intestinal failure persists, and may be, in some selected cases, an indication for intestinal transplantation. RECENT FINDINGS: Biological evaluation of intestinal failure is becoming possible with the use of plasma citrulline as a marker of intestinal mass. Few epidemiological data are available; some indicate an increased incidence of short bowel syndrome-related gastroschisis and persistent high incidence of necrotizing enterocolitis. Morbidity and mortality data in pediatric patients with short bowel syndrome are limited, while long-term outcome is better documented from recently reported cohorts. Non-transplant surgery is one of the best options for patients with unadapted short bowel syndrome. Isolated liver transplantation may be avoided. The use of trophic factors for enhancing mucosal hyperplasia still remains disappointing. SUMMARY: The management should include therapies adapted to each stage of intestinal failure, based on a multidisciplinary approach in centers involving pediatric surgery, pediatric gastroenterology, parenteral nutrition expertise, home-parenteral nutrition program, and liver-intestinal transplantation experience. If managed appropriately, the prognosis of short bowel syndrome is excellent, with limited indications for intestinal and/or liver transplantation. Timing for patient referral in specialized centers remains an issue. SN - 1363-1950 UR - https://www.unboundmedicine.com/medline/citation/16607133/Short_bowel_syndrome_and_intestinal_transplantation_in_children_ L2 - https://doi.org/10.1097/01.mco.0000222116.68912.fc DB - PRIME DP - Unbound Medicine ER -