"Stoma or no stoma": First report of intestinal transplantation without stoma.
clinical research/ practice
intestinal (allograft) function/ dysfunction
intestine/ multivisceral transplantation
patient survival
rejection: acute
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
14
01
2020
revised:
05
04
2020
accepted:
04
05
2020
pubmed:
21
5
2020
medline:
22
6
2021
entrez:
21
5
2020
Statut:
ppublish
Résumé
Recent data suggest that frequent endoscopy and biopsy without evidence of graft dysfunction does not appear to confer survival advantage after intestinal transplantation. After abandoning protocol surveillance, endoscopic examination was decreased significantly at our center. These observations led us to question the need for stoma creation in intestinal transplantation. Herein, we report clinical outcomes of intestinal transplantation without stoma, compared to conventional transplant with stoma. Data analysis was limited to adult intestinal transplantation without liver allograft between 2015 and 2018. We compared patient and graft survival, frequency of endoscopic evaluation, episodes of acute rejection, nutritional therapy, and renal function between "Control group (with stoma)," n = 18 grafts in 16 patients and "Study group (without stoma)," n = 16 grafts in 15 patients. Overall outcome was similar between the 2 groups with respect to graft and patient survival, episodes of acute rejection, and its response to treatment. Nutritional outcomes were similar in both groups. Fewer antidiarrheal medications were required in the study group, but this did not translate into demonstrable gains in preservation of renal function, despite an apparent trend to improvement. Intestinal transplantation without stoma appears to be an acceptable practice model without obvious adverse impact on outcome.
Identifiants
pubmed: 32431016
doi: 10.1111/ajt.16065
pii: S1600-6135(22)21635-9
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3550-3557Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
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