Document Detail


Splanchnic transplantation. An approach to the infant dependent on parenteral nutrition who develops irreversible liver disease.
MedLine Citation:
PMID:  2537436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Two infants with short-bowel syndrome and liver failure associated with obligatory parenteral nutrition received a composite allograft that consisted of en bloc liver, stomach, duodenum, pancreas, jejunum, and ileum. Solutions to the fatal complications in the first case resulted in a functioning composite splanchnic system in the second case. Despite a number of early complications, the small intestine and liver developed near-normal function until a monoclonal, malignant, B-cell lymphoproliferative disorder appeared. The analysis of these two cases supports three summary observations: the operative procedure can be safely performed in a metabolically compromised infant; intestinal allograft rejection, in this model, is controllable with existing immunosuppressive drugs; and this procedure appears to be associated with a uniquely high incidence of lymphoma. Since transplantation is a feasible solution to this devastating infantile disease, further development of this therapy must incorporate means of preventing lymphoma.
Authors:
J W Williams; H N Sankary; P F Foster; J M Loew; G M Goldman; J Lowe
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  261     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-03-24     Completed Date:  1989-03-24     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1458-62     Citation Subset:  AIM; IM    
Affiliation:
Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill 60612.
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MeSH Terms
Descriptor/Qualifier:
Cyclosporins / administration & dosage,  pharmacokinetics
Herpesvirus 4, Human
Humans
Infant
Liver Diseases / etiology,  surgery*
Lymphoproliferative Disorders / immunology*,  pathology
Male
Parenteral Nutrition*
Postoperative Complications* / pathology
Short Bowel Syndrome / etiology,  surgery
Viscera / transplantation*
Chemical
Reg. No./Substance:
0/Cyclosporins
Comments/Corrections
Erratum In:
JAMA 1989 Jul 14;262(2):210
Note: Lowe J [corrected to Loew JM]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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