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- Title
Splanchnic transplantation. An approach to the infant dependent on parenteral nutrition who develops irreversible liver disease.
- Authors
Williams, J W; Sankary, H N; Foster, P F; Loew, J M; Goldman, G M; Lowe, J
- Abstract
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.
- Publication
JAMA: Journal of the American Medical Association, 1989, Vol 261, Issue 10, p1458
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.261.10.1458