Nutritional outcome and growth of children after intestinal transplantation

Purpose: The aim of this study was to determine nutritional outcome and growth in children after successful intestinal transplantation. Methods: Case-record review was conducted of all children who underwent intestinal transplantation at a single center and retained their grafts for at least 1 year. Supplementary data were obtained from outpatient charts and computerized database. Results: Forty-seven intestinal transplants were carried out in 46 children. There were 19 isolated small bowel and 29 combined liver-small bowel transplant procedures. Median age at transplantation was 3.7 years (range, 0.4 to 16.6 years), and median graft survival time was 1,084 days (range, 368 to 3308 days). Nine patients died, and there were 11 graft losses, including those of the nonsurvivors. All survivors with functioning grafts receive all of their calories via the enteral route. There was significant inhibition of linear growth at the time of transplant in the majority of recipients. After successful transplantation, pretransplant growth velocity appeared to be maintained, but there was no evidence of catch-up growth. Conclusions: Intestinal transplantation allows an opportunity for full enteral feedings to be established. There is evidence of severe inhibition of linear growth at the time of transplantation with no evidence of catch-up after transplantation.