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 language | English (US) |
|---|---|
| Journal | Pediatric Transplantation |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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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 journal › Article
}
TY - JOUR
T1 - Complications in pediatric intestine transplantation in the absence of peri-operative donor or recipient bowel decontamination
AU - Clouse, Jared W.
AU - Kubal, Chandrashekhar A.
AU - Fridell, Jonathan A.
AU - Mangus, Richard
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Bowel decontamination
KW - Bowel preparation
KW - Complications
KW - Intestine transplant
KW - Multivisceral transplant
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=85042601250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042601250&partnerID=8YFLogxK
U2 - 10.1111/petr.13164
DO - 10.1111/petr.13164
M3 - Article
C2 - 29498160
AN - SCOPUS:85042601250
JO - Pediatric Transplantation
JF - Pediatric Transplantation
SN - 1397-3142
ER -