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Intestinal transplantation in Czech Republic


Authors: Martin Oliverius 1,8;  Libor Janoušek 1;  Michal Kudla 1;  Petr Wohl 2;  Jan Kopecký 2;  Eva Kieslichová 3;  Dana Němcová 7;  Pavel Trunečka 4;  Pavel Drastich 4;  Eva Honsová 5;  Dana Kautznerová 6;  Hana Baštová 2;  Bohumila Heřmanová 1;  Jiří Froněk 1
Authors place of work: Klinika transplantační chirurgie IKEM, Praha 1;  Centrum diabetologie IKEM, Praha 2;  Klinika anestesiologie a resuscitace IKEM, Praha 3;  Klinika hepatogastroenterologie IKEM, Praha 4;  Pracoviště klinické a transplantační patologie IKEM, Praha 5;  Pracoviště radiodiagnostiky a intervenční radiologie IKEM, Praha 6;  Pracoviště laboratorních metod IKEM, Praha 7;  Chirurgická klinika 3. LF UK a FNKV, Praha 8
Published in the journal: Čas. Lék. čes. 2017; 156: 349-354
Category: Původní práce

Summary

Intestinal transplantation represents a suitable treatment for patients with intestinal failure who then develop life-threatening complications of total parenteral nutrition and for some patients with complex abdominal disorders not suitable for conventional treatment.

Methods:
prior to launch of the clinical program, preparation started in 2006 initially with extensive experimentation carried out on pigs. The clinical phase involved a specialized, multidisciplinary team who examined 23 patients being considered for transplantation. Seven patients were put on a waiting list and one female, due to the improvement of her medical status, was unlisted. The first ever intestinal transplantation was done in 2014.

Results:
three out of six transplanted patients are alive with 380 days of actual survival; median 131 days (63–763). Two patients are on a full oral diet and nutritionally independent with an excellent quality of life. One female is nutritionally independent but with the need for partial supplemental parenteral rehydration due to the stomal output.

Conclusion:
intestinal transplantation is a suitable treatment for highly selected patients with intestinal failure who meet specific listing criteria.

Keywords:
intestinal transplantation, multivisceral transplantation, intestinal failure, parenteral nutrition, short bowel syndrome


Zdroje

1. Oliverius M, Baláž P, Kudla M et al. Small bowel graft revascularization in experiment. Bratislavské lekárske listy 2009; 110(2): 65–68.

2. Baláž P, Kudla M, Lodererová A et al. Preservation injury of the small bowel graft in clinical small bowel transplantation. Bratislavské lekárske listy 2007; 108(12): 516–8.

3. Oliverius M, Kudla M, Baláž P et al. Transplantatace tenkého střeva v experimentu. Rozhledy v chirurgii 2009; 88(11): 662–668.

4. Oliverius M, Kudla M, Baláž P, Valsamis A. Hladina plazmatického citrulinu - spolehlivý neinvazivní ukazatel množství funkčních enterocytů. Časopis lékařů českých 2010; 149(4): 160–162.

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8. Salvino R, Ghanta R, Seidner DL et al. Liver failure is uncommon in adults receiving long-term parenteral nutrition. J Parenter Enteral Nutr 2006; 30(3): 202–208.

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15. Pironi L, Hébuterne X, Van Gossum A et al. Candidates for intestinal transplantation: a multicenter survey in Europe. Am J Gastroenterol 2006; 101(7): 1633–1643.

16. Pironi L, Forbes A, Joly F et al. Survival of patients identified as candidates for intestinal transplantation: a 3-year prospective follow-up. Gastroenterology 2008; 135(1): 61–71.

17. Matsumoto CS, Kaufman SS, Fishbein TM. Inclusion of the colon in intestinal transplantation. Curr Opin Organ Transplant 2011; 16(3): 312–315.

18. Huard G, Schiano T, Moon J, Iyer K. Choice of Allograft in Patients Requiring Intestinal Transplantation: A Critical Review. Can J Gastroenterol Hepatol 2017: 1069726.

19. Abu-Elmagd KM, Costa G, Bond GJ et al. Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challenges. Ann Surg 2009; 250(4): 567–581.

20. Berger M, Zeevi A, Farmer DG, Abu-Elmagd KM. Immunologic challenges in small bowel transplantation. Am J Transplant 2012; 12(Suppl. 4): S2–S8.

Štítky
Adiktológia Alergológia a imunológia Angiológia Audiológia a foniatria Biochémia Dermatológia Detská gastroenterológia Detská chirurgia Detská kardiológia Detská neurológia Detská otorinolaryngológia Detská psychiatria Detská reumatológia Diabetológia Farmácia Chirurgia cievna Algeziológia Dentální hygienistka

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