Department of Surgery, Division of Pediatric Transplantation, Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
Gastroenterol Clin North Am. 2018 Jun;47(2):355-368. doi: 10.1016/j.gtc.2018.01.007. Epub 2018 Apr 4.
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving. Long-term outcomes have improved, but challenges in long-term graft function owing to chronic rejection and immunosuppressant-related complications remain the major opportunities for improvement.
小儿肠移植已从理论治疗转变为不可逆肠衰竭儿童的实际治疗方法，这些儿童因全胃肠外营养的并发症而受苦。由于在管理肠衰竭和预防肠外营养相关并发症方面取得了显著进展，导致肠外营养相关肝病的发病率降低，并且改善了肠适应，因此肠移植的适应证也在不断发展。长期结果有所改善，但由于慢性排斥和免疫抑制剂相关并发症导致移植物长期功能障碍，仍然是需要改进的主要机会。
