Long-term nutrition and predictors of growth and weight gain following pediatric intestinal transplantation

Robert S. Venick, Laura J. Wozniak, Joanie Colangelo, Patty Beckwith, Laurie Reyen, Yvonne A. Esmailian, Sue V. McDiarmid, Jorge H. Vargas, Marvin E. Ament, Ronald W. Busuttil, Douglas G. Farmer

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations

Abstract

BACKGROUND.: Advances in intestinal transplantation (ITx) have resulted in improved survival and the opportunity to examine nutritional outcomes. The aim of this study was to describe detailed, long-term nutritional results and identify positive predictors of growth and weight gain following pediatric ITx. METHODS.: A single-center retrospective, Institutional Review Board-approved review of a prospective database was conducted. Inclusion criteria were ITx recipients 18 years or younger with survival of 6 months or more. Outcomes included anthropometric measurements and biochemical markers at 6, 12, 24, 36, and 48 months post-ITx. More than 25 ITx-related variables were analyzed as potential predictors of growth and weight gain. Statistical analysis was performed using chi-square test, t test, and analysis of variance. RESULTS.: Between November 1991 and April 2007, 50 children received 55 ITx; 33 patients met eligibility criteria. Median age at ITx was 2.2 years, follow-up time was 3.8 years, and time from ITx to cessation of total parenteral nutrition was 31 days. The most common micronutrient deficiencies post-ITx were zinc, iron, and copper. Serum protein levels improved significantly over time. Weight gain occurred within 6 months and vertical growth within 12 months, although limited catch-up growth was seen. Early predictors of weight gain and growth included shorter hospitalization and absence of rejection. Long-term predictors were low steroid dosage, infrequent hospitalization, and the use of peptide-based formulas. CONCLUSIONS.: This represents one of the largest and most comprehensive long-term studies on nutritional outcomes in pediatric ITx. Overall, positive growth and weight gain were seen as were micronutrient deficiencies. Numerous long-term nutritional challenges exist which require a multidisciplinary approach and future prospective studies.

Original languageEnglish (US)
Pages (from-to)1058-1062
Number of pages5
JournalTransplantation
Volume92
Issue number9
DOIs
StatePublished - Nov 15 2011

Keywords

  • Intestinal transplantation
  • Nutrition
  • Pediatric

ASJC Scopus subject areas

  • Transplantation

Fingerprint

Dive into the research topics of 'Long-term nutrition and predictors of growth and weight gain following pediatric intestinal transplantation'. Together they form a unique fingerprint.

Cite this