Complications in pediatric intestine transplantation in the absence of peri-operative donor or recipient bowel decontamination

Jared W. Clouse, Chandrashekhar A. Kubal, Jonathan A. Fridell, Richard Mangus

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%). The rate of any bacterial infection was 90% in the first year, with a wound infection rate of 23%. Any fungal infection occurred in 25% of patients. Any viral infection occurred in 75% of patients. Gastrointestinal viruses were diagnosed in 52% of patients, and cytomegalovirus infections occurred in 17%. Rejection rates were 39% at any time post-transplant (isolated 44% and 35% for multivisceral patients). At this center in which no bowel decontamination was used, rates of surgical complications, infections, and rejection were similar to those reported by other centers. These findings suggest bowel decontamination may provide no significant benefit in this population of high-risk transplant patients.

Original languageEnglish (US)
JournalPediatric Transplantation
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Decontamination
Intestines
Transplantation
Tissue Donors
Pediatrics
Transplants
Anastomotic Leak
Mycoses
Cytomegalovirus Infections
Virus Diseases
Wound Infection
Immunosuppressive Agents
Infection
Bacterial Infections
Abscess
Fistula
Viruses

Keywords

  • Bowel decontamination
  • Bowel preparation
  • Complications
  • Intestine transplant
  • Multivisceral transplant
  • Outcomes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Complications in pediatric intestine transplantation in the absence of peri-operative donor or recipient bowel decontamination. / Clouse, Jared W.; Kubal, Chandrashekhar A.; Fridell, Jonathan A.; Mangus, Richard.

In: Pediatric Transplantation, 01.01.2018.

Research output: Contribution to journalArticle

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