Summary Background: Pediatric patients with irreversible intestinal failure present multiple challenges due to their young ages and their associated growth needs. We have previously published promising short-term results in pediatric living related small bowel transplantation (LRSBtx). This study describes long-term outcomes of LRSBTx on growth and quality of life in children with more than 10 years follow-up.

Patients and Methods: From October 2002 to December 2015, 10 children underwent LRSBTx at our center. Six patients with greater than 10 years follow up were included in the study. Mean age was 2 years (range, 12-53 months). Grafts transplanted included isolated small bowel transplant (n = 3) and combined liver-small bowel transplant (n = 3). All patients were maintained on Tacrolimus based immunosuppression. Weight and height were collected (pre-transplant and at 1, 3, 5, 7 and 10 years after transplant) and analyzed using z-scores.

Results:The average time to initiation of oral diet was 32 days (range, 13-202 days) and the median day for ileostomy taking down was 57 days (range, 27-224 days). Six children (100%) currently maintain a normal diet with oral supplements based on nutritional needs. All patients remain independent from TPN. Five children (83.3%) are currently enrolled in school and one child is home-schooled. All children report good quality of life with great adaptation to daily life activities. We observed an improvement in growth during the first year post-transplant (Figure 1) and progressive weight gain throughout the first 3 years post-transplant (Figure 2). Growth rate and weight gain decreased after these time periods. Evaluation of both mean height z-scores at 1 year post-transplant and mean weight z-scores 1 and 3 years after transplant were found to be statistically significant as compared to pre-transplant mean Z-scores.

Conclusion: Living donor small bowel transplantation represents an acceptable therapy for children with irreversible intestinal failure and offers a good quality of life long term with positive growth and weight gain.

CITATION INFORMATION: Garcia Aroz S, Tzvetanov I, Hetterman E, Hoonbae J, Spaggiari M, Oberholzer J, Testa G, John E, Benedetti E. Living Related Small Bowel Transplantation in Children, a Single-Center Experience – Growth, Development and Quality of Life 10 Years After Transplant. Am J Transplant. 2016;16 (suppl 3).

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