Peer-reviewed article
Long-term growth and nutrition outcomes in children following intestinal transplantation.
Ahmad Miri, Angela K Iverson, Nathan Law, Junghyae Lee, Ruben E Quiros Navarrete et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a clinical study of intestinal transplantation outcomes in children with intestinal failure. It examines growth and nutrition in 133 children followed for up to 15 years after transplant surgery. The study found improvements in height but declining weight, and identified factors that delay weaning from tube feeding.
Key points
- Height z-scores improved significantly over 15 years post-transplant
- Body mass index z-scores showed a downward trend over time
- Children with developmental delay, partial gastrectomy, or permanent ostomy were more likely to need long-term tube feeding
- Steroid use and dose did not significantly affect growth outcomes
- Isolated intestinal transplant patients had better height outcomes than multivisceral transplant patients
Limitations
This is a retrospective clinical case series focused on a rare surgical intervention for a small population of severely ill children with intestinal failure, not a representative study of child nutrition or well-being more broadly. The findings relate only to post-transplant outcomes and do not address prevention or broader nutritional health in the general child population.
Abstract
OBJECTIVE: Intestinal transplantation (ITx) has become an accepted option for children with serious complications from intestinal failure and parenteral nutrition (PN) dependence. We aimed to assess long-term growth and nutritional outcomes in these patients. We also assessed factors influencing nutritional status and ability to wean off tube feedings (TFs) after ITx. METHODS: We looked retrospectively into post-ITx growth parameters, nutrition treatment, and micronutrient status for children who survived for 5 or more years after ITx. One hundred thirty-three children between 1993 and 2014 were involved. Descriptive data and growth parameters were collected over 15 years after ITx. We also analyzed influencing factors, including the presence of permanent stoma, prolonged use of steroids, partial gastrectomy at the time of ITx, developmental delay, concurrent visceral transplant, and graft rejection episodes. RESULTS: There was an increase in the height z-scores over the 15-year period post-ITx (p < 0.001). There was a downward trend in body mass index (BMI) z-scores over the 15-year post-ITx period. Isolated intestinal transplant patients showed a better height z-score compared to multivisceral transplant (p = 0.04). The height and BMI z-scores for patients on steroids were not significantly different from the z-scores for steroid-free patients (p = 0.72, 0.99, respectively). There was no significant change in height and BMI z-scores based on prednisolone dose: ≤0.2 mg/kg (p = 0.76); >0.2 mg/kg (p = 0.52). Patients were more likely to require supplemental TF up to 15 years post-ITx when they had partial gastrectomy (p < 0.001), permanent ostomy (p = 0.009), or developmental delay (p < 0.001). CONCLUSIONS: There was improved long-term linear growth post-ITx. Developmental delay, partial gastrectomy, and a permanent ostomy are likely to delay TF wean post-ITx.