Intestinal and Multivisceral Transplantation after Abdominal Trauma

Seigo Nishida, Nicholas S. Hadjis, David M. Levi, Tomoaki Kato, Anil Vaidya, Jose R. Nery, Juan Madariaga, Noboru Nakamura, Phillip Ruiz, Guy Neff, Patricia M Byers, Andreas G. Tzakis

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Some trauma victims who survive acute illness develop lingering, debilitating syndromes that are incompatible with any semblance of normalcy. Intestinal failure, in particular, exacts a high price in terms of quality of life. Total parenteral nutrition (TPN) has served these patients well, but complications limit its long-term therapeutic effect. Consequently, transplantation is emerging as a life-saving therapy for some patients with the short gut syndrome. Methods: We reviewed eight adult and two pediatric recipients of intestinal and multivisceral transplants after severe abdominal trauma. Background demographics, type of abdominal trauma, transplant procedure, postoperative complications, and survival rates were appraised. This group was also compared with 47 nontrauma recipients of intestinal transplants performed during the same period. Results: Four patients (40%) died postoperatively (postoperative days 7, 53, 87, and 91) as a result of multiple organ failure after graft pancreatitis (n = 1), viral encephalitis (n = 1), and sepsis after severe rejection (n = 2). Six patients (60%) are alive (postoperative days 52-1,783). All are off TPN. The 4-year patient survival was 58%, with no significant difference between trauma and nontrauma patients. Conclusion: Intestinal and multivisceral transplantation are viable options for the treatment of irreversible intestinal failure associated with severe trauma. Surviving patients are TPN independent and have a satisfactory quality of life.

Original languageEnglish
Pages (from-to)323-327
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume56
Issue number2
StatePublished - Mar 16 2004

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Keywords

  • Abdominal
  • Intestinal
  • Intestinal failure
  • Multivisceral
  • Short gut syndrome
  • Total parenteral nutrition
  • Transplantation
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Nishida, S., Hadjis, N. S., Levi, D. M., Kato, T., Vaidya, A., Nery, J. R., Madariaga, J., Nakamura, N., Ruiz, P., Neff, G., Byers, P. M., & Tzakis, A. G. (2004). Intestinal and Multivisceral Transplantation after Abdominal Trauma. Journal of Trauma - Injury, Infection and Critical Care, 56(2), 323-327.