Intestinal transplantation in children: Preliminary experience in Paris

From November 1994 to November 1998, 20 children (2.5 to 14 years) received a jejunoileal graft alone (SBTx; n = 10) or in combination with the liver (SELTx; n = 10 and/or the right colon (5 SBTx). Indications were intractabl e diarrhea of infancy (n = 8), short bowel syndrome (n = 6), extensive Hirs chsprung disease (n = 4), and chronic intestinal pseudoobstruction (n = 2). Immunosuppression included tacrolimus, methylprednisolone, and azathioprin e. Current follow-up ranges from 6 to 54 months. Five patients died (3 SBTx ) within the first 2 months. Acute liver rejection occurred in 5 patients d uring the first 2 months. Sixteen episodes of intestinal rejection during t he first 3 months in 11 patients (8 in 4 SBTx) were successfully treated in all but 3 by increasing tacrolimus dose and/or a 3-day methyprednisolone b olus or required antilymphoglobulins in 3 cases. Surgical complications occ urred 8 times after SBLTx and 3 after SBTx. Infectious complications were m ore frequent in SBLTx