Soltys Kyle A, Bond Geoff, Sindhi Rakesh, Rassmussen Sara K, Ganoza Armando, Khanna Ajai, Mazariegos George
The Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, 4401 Penn Ave, 6 FP, Pittsburgh, PA 15224.
The Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, 4401 Penn Ave, 6 FP, Pittsburgh, PA 15224.
Semin Pediatr Surg. 2017 Aug;26(4):241-249. doi: 10.1053/j.sempedsurg.2017.07.007. Epub 2017 Jul 25.
The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term survival. As experience has grown, newer diseases, with more systemic manifestations have arisen as potential indications for transplant. After discussing the historical developments of intestinal transplant as a backdrop, this review focuses on the specific pre-operative indications for transplant as well as the great success that intestinal rehabilitation has witnessed over the past decade. A detailed discussion of evolution of immunosuppressive strategies is followed a general review of the common infectious complications experienced by children after intestinal transplant as well as the current long- and short-term results, including a section on new research on the quality of life in this challenging population of patients.
自30年前首次报道肠道移植病例以来，肠道移植领域经历了显著的发展。手术技术、供体评估和免疫抑制方案的改进，为患有危及生命的肠道衰竭并发症的儿童提供了长期生存的机会。随着经验的积累，出现了具有更多全身表现的新疾病，成为潜在的移植适应症。在以肠道移植的历史发展为背景进行讨论之后，本综述重点关注肠道移植的具体术前适应症，以及肠道康复在过去十年中所取得的巨大成功。在详细讨论免疫抑制策略的演变之后，对肠道移植术后儿童常见的感染并发症以及当前的长期和短期结果进行了全面综述，其中包括一部分关于这一具有挑战性的患者群体生活质量的新研究。
