Long-Term Nutrition and Predictors of Growth and Weight Gain Following Pediatric Intestinal Transplantation

作者：Robert S. Venick, Laura J. Wozniak, Joanie Colangelo, Patty Beckwith, Laurie Reyen, Yvonne Esmailian, Sue V. McDiarmid, Jorge H. Vargas, Marvin E. Ament, Ronald W. Busuttil, Douglas G. Farmer · 发表于：Transplantation · 年份：2011 · DOI：10.1097/tp.0b013e31822f2b1b · 被引用次数：38 · 研究领域：Clinical Nutrition and Gastroenterology、Nutrition and Health in Aging、Organ Transplantation Techniques and Outcomes

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 hospita...