Our Summary

This research paper discusses the complications that can occur after a child has received a specific type of intestinal transplant, known as an ER. These complications can lead to serious health problems and even death. The paper describes three cases of children who had complications several months after their transplants. These complications included a narrowing of the transplanted intestine, a bruise that caused a hole in the transplanted intestine, and a severe internal bleed caused by an ulcer and abnormal tissue growth.

In all three cases, the doctors were able to see that new lining was growing in the intestine. This allowed them to surgically remove the problematic sections of the transplanted intestine, hopefully to improve the overall function of the transplanted organ. Two of the three children did well after this procedure and their transplanted intestines continued to work well for over three years. Unfortunately, the third child developed a type of cancer linked to the transplant and later died from a viral infection over four years after the surgery.

This research highlights the importance of quickly identifying and managing complications after an intestinal transplant. By doing so, doctors may be able to save the transplanted organ and improve the chances of survival for the patient.

FAQs

  1. What are some of the complications of ER that can occur after intestinal transplantation?
  2. How can surgical intervention help in allograft salvage and patient survival after ER?
  3. What is the timeframe for ER after transplantation as observed in the study?

Doctor’s Tip

A doctor might advise a patient who has undergone intestinal resection to be vigilant for any signs of complications such as abdominal pain, bloating, changes in bowel habits, or fever. It is important to follow a nutritious diet high in fiber and drink plenty of water to promote healthy digestion and prevent constipation. Regular exercise can also help improve intestinal function. It is essential to attend all follow-up appointments and adhere to any prescribed medications to prevent further complications and promote healing.

Suitable For

Patients who are typically recommended intestinal resection are those who have undergone intestinal transplantation and experience complications of late acute allograft rejection (ER). In particular, patients who develop severe complications such as allograft stricture, intramural hematoma with perforation, and massive gastrointestinal hemorrhage may require surgical intervention. Prompt recognition and surgical correction of these complications can play a crucial role in allograft salvage and patient survival after ER.

Timeline

  • Patients undergo composite LSB transplantation between one and two years of age
  • Time to ER after transplantation ranges from 9.5 to 26.5 months
  • ER complications include ileal allograft stricture, intramural hematoma with perforation of jejunal allograft, and massive GI hemorrhage
  • Patients undergo limited segmental allograft resection with evidence of mucosal regeneration
  • Two patients maintain satisfactory allograft function 39-44 months post-operation
  • Third patient develops PTLD and dies from disseminated Adenovirus infection 51 months after resection
  • Prompt recognition and surgical correction of complications play a crucial role in allograft salvage and patient survival after ER.

What to Ask Your Doctor

  1. What are the potential complications of intestinal resection?
  2. How long is the recovery period after intestinal resection?
  3. Will I need to make any changes to my diet or lifestyle post-surgery?
  4. What are the risks and benefits of undergoing intestinal resection?
  5. How will intestinal resection affect my overall health and quality of life?
  6. Are there any alternative treatment options to intestinal resection?
  7. How often will I need follow-up appointments after the surgery?
  8. What is the success rate of allograft salvage after limited surgical resection in patients like me?
  9. Will I need to take any medications long-term after intestinal resection?
  10. How can I prevent complications or recurrence of issues after intestinal resection?

Reference

Authors: Goldschmidt ML, Kocoshis SA, Tiao GM, Alonso MH, Nathan JD. Journal: Pediatr Transplant. 2015 Nov;19(7):E170-6. doi: 10.1111/petr.12563. Epub 2015 Jul 31. PMID: 26230722