Intestinal transplantation for short bowel syndrome secondary to gastroschisis

Wada, Motoshi; Kato, Tomoaki; Hayashi, Yutaka; Selvaggi, G.; Mittal, N.; Thompson, J.; Gonzalez, M.; Nishida, S.; Madariaga, J.; Tzakis, A.

doi:10.1016/j.jpedsurg.2006.06.010

« Previous Next »Journal of Pediatric Surgery
Volume 41, Issue 11 , Pages 1841-1845, November 2006

Intestinal transplantation for short bowel syndrome secondary to gastroschisis

The abstract of this study was partly presented at the XX International Congress of the Transplantation Society, September 5-10, 2004, Vienna, Austria.

Motoshi Wada
- Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai 980-8574, Japan
Tomoaki Kato
- Divisions of Liver and GI Transplant, University of Miami School of Medicine, Miami, FL 33136, USA
- Corresponding author.
Yutaka Hayashi
- Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai 980-8574, Japan
G. Selvaggi
- Divisions of Liver and GI Transplant, University of Miami School of Medicine, Miami, FL 33136, USA
N. Mittal
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, University of Miami School of Medicine, Miami, FL 33136, USA
J. Thompson
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, University of Miami School of Medicine, Miami, FL 33136, USA
M. Gonzalez
- Department of Pathology, University of Miami, University of Miami School of Medicine, Miami, FL 33136, USA
S. Nishida
- Divisions of Liver and GI Transplant, University of Miami School of Medicine, Miami, FL 33136, USA
J. Madariaga
- Divisions of Liver and GI Transplant, University of Miami School of Medicine, Miami, FL 33136, USA
A. Tzakis
- Divisions of Liver and GI Transplant, University of Miami School of Medicine, Miami, FL 33136, USA

Abstract

Background/Purpose

Gastroschisis is the most frequent cause of pediatric intestinal transplantation. This study reviews our experience of intestinal transplantation secondary to gastroschisis to elucidate those factors affecting the outcome of children with short bowel syndrome.

Methods

A retrospective review was performed for children who underwent intestinal transplantation for gastroschisis at the University of Miami between June 2003 and August 1994.

Results

Thirty-two transplants were performed in 28 children with gastroschisis during the study period. Associated intestinal anomalies were present in 22 infants (atresia [n = 14], volvulus [n = 3], and/or ischemia [n = 16]). Spontaneous prenatal closure of gastroschisis, a rare anomaly associated with bowel atresia and ischemia because of a very small abdominal defect, was seen in 9 patients. Most of the patients had a complicated course and required multiple abdominal surgeries before transplant. Fifteen (53.6%) patients are currently alive at a median follow-up of 23.5 months. Short-term survival rate has significantly improved in recent years.

Conclusions

Patients with complex gastroschisis and intestinal anomalies have a significant risk for progression to short bowel syndrome. Intestinal transplantation can be a lifesaving option and provides a satisfactory outcome for children with short bowel syndrome secondary to gastroschisis.