Gut Failure in Pediatric and Adult Patients: Candidates for Small-Bowel Transplantation in Southern Finland

Abstract

Background: This study investigated the need for small-bowel transplantation (SBT) in southern Finland. In addition, we evaluated the effect of colon resection on the time required for intestinal adaptation in patients with gut failure.

Methods: Mortality, morbidity, intestinal adaptation time, and surgical management were evaluated retrospectively in 24 patients (12 adults and 12 children) with jejunoileal exclusion. Of the 24 patients 19 had undergone accompanying colon resection.

Results: Intestinal adaptation had occurred in 12 of 18 survivors (67%). Two unadapted survivors were considered to be currently suitable candidates for SBT. The length of the remaining colon was inversely correlated (correlation coefficient r = -0.789; p < 0.0001) with the duration of intestinal adaptation.

Conclusions: Each year one to two patients per 1.27 million people could benefit from SBT in southern Finland. The length of the remaining colon is a major determinant of the duration of intestinal adaptation in patients with massive jejunoileal resection.

Key Words:

• Colon resection
• intestinal adaptation
• jejunoileal resection
• short-bowel syndrome
• small-bowel transplantation