Small Bowel Transplantation as a Final Treatment for Intestinal Failure View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2002

AUTHORS

Akira Okada , Toshimichi Hasegawa , Masafumi Wasa , Tatsuo Azuma

ABSTRACT

As a consequence of recent advances in long-term total parenteral nutrition (TPN), intestinal failure has come to be recognized as an established pathological entity. However, a number of problems remain to be answered before long-term TPN is widely and safely performed. The most serious and important of these are catheter-related sepsis and liver dysfunction. When it becomes impossible to continue TPN because of these complications, small bowel transplantation (SBT) is considered as the treatment of choice. In Japan, the first SBT was performed in Kyoto in 1998, and since then three more cases, including this one, have followed. The case we treated is that of a 16-year-old boy with a diagnosis of microvillus inclusion disease who had been receiving long-term TPN for persistent diarrhea since birth. When he developed liver dysfunction with hepatosplenomegaly, a living-related intestinal transplantation was performed, with the donor being his 59-year-old blood-matched grandmother. The postoperative course was uneventful. Enteral feeding was started on postoperative day 14, and later he was switched to an oral diet. TPN was discontinued 5 months postoperatively, and he is doing well so far.Regarding the number of candidates for intestinal transplantation in Japan, an annual survey of patients receiving home parenteral nutrition is available from the Registry Promotion Committee of the Japanese Society for Home Parenteral Nutrition (HPN). According to the latest survey in 2000, a total of 355 patients (malignant, 202; benign, 149) are presently receiving HPN. If we assume that half of the patients with benign disease would potentially be real candidates for SBT, there would be 75 patients on the list. More... »

PAGES

115-121

Book

TITLE

Current Issues in Liver and Small Bowel Transplantation

ISBN

978-4-431-68005-5
978-4-431-67889-2

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-4-431-67889-2_16

DOI

http://dx.doi.org/10.1007/978-4-431-67889-2_16

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029732463


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