Skip to main content
Erschienen in: Pediatric Surgery International 8/2017

09.06.2017 | Original Article

A meta-analysis of clinical outcome of intestinal transplantation in patients with total intestinal aganglionosis

verfasst von: Hiroki Nakamura, Davina Henderson, Prem Puri

Erschienen in: Pediatric Surgery International | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Aim of the study

Total intestinal aganglionosis (TIA) occurs in less than 1% of patients with Hirschsprung disease (HD), and TIA is the most severe form of HD. Survival has improved with the advent of parenteral nutrition and intestinal transplantation (ITx). The field of ITx has rapidly progressed in the last two decades and has now become an established treatment for patients with intestinal failure. The purpose of this meta-analysis was to determine the clinical outcome of ITx in patients with TIA.

Methods

A systematic literature search for relevant articles was performed in four databases using the combinations of the following terms: “total intestinal aganglionosis”, “intestinal transplantation”, and “Hirschsprung disease/Hirschsprung’s disease” for studies published between 2003 and 2016. The relevant cohorts of ITx in patients with TIA were systematically searched for clinical outcomes.

Main results

Thirteen studies met defined inclusion criteria, reporting a total of 63 patients who underwent ITx for TIA. Majority of patients were males (71.0%), and median age of ITx was 4.3 (range 0.25–17.6) years. Isolated ITx was performed in 37% patients and multivisceral ITx in 63%. Mean follow-up period was 40 months (range 1–154). Overall survival rate was 66%; the longest survivor was 12.8-year-old after ITx.

Conclusion

ITx appears promising in the management of TIA. ITx can be considered a feasible treatment option for patients with TIA who suffer from life-threatening complications of intestinal failure.
Literatur
1.
Zurück zum Zitat Caniano DA, Ormsbee HS 3rd, Polito W, Sun CC, Barone FC, Hill JL (1985) Total intestinal aganglionosis. J Pediatr Surg 20(4):456–460CrossRefPubMed Caniano DA, Ormsbee HS 3rd, Polito W, Sun CC, Barone FC, Hill JL (1985) Total intestinal aganglionosis. J Pediatr Surg 20(4):456–460CrossRefPubMed
3.
4.
Zurück zum Zitat Coran AG, Teitelbaum DH (2000) Recent advances in the management of Hirschsprung’s disease. Am J Surg 180(5):382–387CrossRefPubMed Coran AG, Teitelbaum DH (2000) Recent advances in the management of Hirschsprung’s disease. Am J Surg 180(5):382–387CrossRefPubMed
5.
Zurück zum Zitat Solari V, Ennis S, Yoneda A, Wong L, Messineo A, Hollwarth ME, Green A, Puri P (2003) Mutation analysis of the RET gene in total intestinal aganglionosis by wave DNA fragment analysis system. J Pediatr Surg 38(3):497–501. doi:10.1053/jpsu.2003.50087 CrossRefPubMed Solari V, Ennis S, Yoneda A, Wong L, Messineo A, Hollwarth ME, Green A, Puri P (2003) Mutation analysis of the RET gene in total intestinal aganglionosis by wave DNA fragment analysis system. J Pediatr Surg 38(3):497–501. doi:10.​1053/​jpsu.​2003.​50087 CrossRefPubMed
6.
Zurück zum Zitat Rudin C, Jenny PM, Fliegel CP, Ohnacker H, Heitz PU (1986) Zuelzer–Wilson’s syndrome and absence of the enteric nervous system. Two rare forms of anomalies of the enteric nervous system with identical clinical symptoms. Z Kinderchir 41(5):287–292. doi:10.1055/s-2008-1043361 PubMed Rudin C, Jenny PM, Fliegel CP, Ohnacker H, Heitz PU (1986) Zuelzer–Wilson’s syndrome and absence of the enteric nervous system. Two rare forms of anomalies of the enteric nervous system with identical clinical symptoms. Z Kinderchir 41(5):287–292. doi:10.​1055/​s-2008-1043361 PubMed
7.
Zurück zum Zitat Rudin C, Jenny P, Ohnacker H, Heitz PU (1986) Absence of the enteric nervous system in the newborn: presentation of three patients and review of the literature. J Pediatr Surg 21(4):313–318CrossRefPubMed Rudin C, Jenny P, Ohnacker H, Heitz PU (1986) Absence of the enteric nervous system in the newborn: presentation of three patients and review of the literature. J Pediatr Surg 21(4):313–318CrossRefPubMed
8.
Zurück zum Zitat Sauvat F, Grimaldi C, Lacaille F, Ruemmele F, Dupic L, Bourdaud N, Fusaro F, Colomb V, Jan D, Cezard JP, Aigrain Y, Revillon Y, Goulet O (2008) Intestinal transplantation for total intestinal aganglionosis: a series of 12 consecutive children. J Pediatr Surg 43(10):1833–1838. doi:10.1016/j.jpedsurg.2008.03.028 CrossRefPubMed Sauvat F, Grimaldi C, Lacaille F, Ruemmele F, Dupic L, Bourdaud N, Fusaro F, Colomb V, Jan D, Cezard JP, Aigrain Y, Revillon Y, Goulet O (2008) Intestinal transplantation for total intestinal aganglionosis: a series of 12 consecutive children. J Pediatr Surg 43(10):1833–1838. doi:10.​1016/​j.​jpedsurg.​2008.​03.​028 CrossRefPubMed
9.
Zurück zum Zitat Sigurdsson L, Reyes J, Kocoshis SA, Mazariegos G, Abu-Elmagd KM, Bueno J, Di Lorenzo C (1999) Intestinal transplantation in children with chronic intestinal pseudo-obstruction. Gut 45(4):570–574CrossRefPubMedPubMedCentral Sigurdsson L, Reyes J, Kocoshis SA, Mazariegos G, Abu-Elmagd KM, Bueno J, Di Lorenzo C (1999) Intestinal transplantation in children with chronic intestinal pseudo-obstruction. Gut 45(4):570–574CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Rovera GM, Schoen RE, Goldbach B, Janson D, Bond G, Rakela J, Graham TO, O’Keefe S, Abu-Elmagd K (2003) Intestinal and multivisceral transplantation: dynamics of nutritional management and functional autonomy. JPEN J Parenter Enter Nutr 27(4):252–259. doi:10.1177/0148607103027004252 CrossRef Rovera GM, Schoen RE, Goldbach B, Janson D, Bond G, Rakela J, Graham TO, O’Keefe S, Abu-Elmagd K (2003) Intestinal and multivisceral transplantation: dynamics of nutritional management and functional autonomy. JPEN J Parenter Enter Nutr 27(4):252–259. doi:10.​1177/​0148607103027004​252 CrossRef
11.
Zurück zum Zitat Bond GJ, Reyes JD (2004) Intestinal transplantation for total/near-total aganglionosis and intestinal pseudo-obstruction. Semin Pediatr Surg 13(4):286–292CrossRefPubMed Bond GJ, Reyes JD (2004) Intestinal transplantation for total/near-total aganglionosis and intestinal pseudo-obstruction. Semin Pediatr Surg 13(4):286–292CrossRefPubMed
12.
Zurück zum Zitat Fouquet V, De Lagausie P, Faure C, Bloch J, Malbezin S, Ferkhadji L, Bauman C, Aigrain Y (2002) Do prognostic factors exist for total colonic aganglionosis with ileal involvement? J Pediatr Surg 37(1):71–75CrossRefPubMed Fouquet V, De Lagausie P, Faure C, Bloch J, Malbezin S, Ferkhadji L, Bauman C, Aigrain Y (2002) Do prognostic factors exist for total colonic aganglionosis with ileal involvement? J Pediatr Surg 37(1):71–75CrossRefPubMed
13.
Zurück zum Zitat Kleinhaus S, Boley SJ, Sheran M, Sieber WK (1979) Hirschsprung’s disease—a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 14(5):588–597CrossRefPubMed Kleinhaus S, Boley SJ, Sheran M, Sieber WK (1979) Hirschsprung’s disease—a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 14(5):588–597CrossRefPubMed
14.
17.
Zurück zum Zitat Fortuna RS, Weber TR, Tracy TF Jr, Silen ML, Cradock TV (1996) Critical analysis of the operative treatment of Hirschsprung’s disease. Arch Surg 131(5):520–524 (discussion -524–525) CrossRefPubMed Fortuna RS, Weber TR, Tracy TF Jr, Silen ML, Cradock TV (1996) Critical analysis of the operative treatment of Hirschsprung’s disease. Arch Surg 131(5):520–524 (discussion -524–525) CrossRefPubMed
18.
Zurück zum Zitat Marty TL, Seo T, Matlak ME, Sullivan JJ, Black RE, Johnson DG (1995) Gastrointestinal function after surgical correction of Hirschsprung’s disease: long-term follow-up in 135 patients. J Pediatr Surg 30(5):655–658CrossRefPubMed Marty TL, Seo T, Matlak ME, Sullivan JJ, Black RE, Johnson DG (1995) Gastrointestinal function after surgical correction of Hirschsprung’s disease: long-term follow-up in 135 patients. J Pediatr Surg 30(5):655–658CrossRefPubMed
19.
Zurück zum Zitat Ziegler MM, Royal RE, Brandt J, Drasnin J, Martin LW (1993) Extended myectomy–myotomy. A therapeutic alternative for total intestinal aganglionosis. Ann Surg 218(4):504–509 (discussion 509–511) CrossRefPubMedPubMedCentral Ziegler MM, Royal RE, Brandt J, Drasnin J, Martin LW (1993) Extended myectomy–myotomy. A therapeutic alternative for total intestinal aganglionosis. Ann Surg 218(4):504–509 (discussion 509–511) CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Shimotake T, Go S, Tomiyama H, Aoi S, Iwai N (2002) Proximal jejunostomy with or without myectomy–myotomy modification in five infants with total intestinal aganglionosis: an experience with surgical treatments in a single institution. J Pediatr Surg 37(6):835–839CrossRefPubMed Shimotake T, Go S, Tomiyama H, Aoi S, Iwai N (2002) Proximal jejunostomy with or without myectomy–myotomy modification in five infants with total intestinal aganglionosis: an experience with surgical treatments in a single institution. J Pediatr Surg 37(6):835–839CrossRefPubMed
22.
Zurück zum Zitat Ziegler MM, Ross AJ 3rd, Bishop HC (1987) Total intestinal aganglionosis: a new technique for prolonged survival. J Pediatr Surg 22(1):82–83CrossRefPubMed Ziegler MM, Ross AJ 3rd, Bishop HC (1987) Total intestinal aganglionosis: a new technique for prolonged survival. J Pediatr Surg 22(1):82–83CrossRefPubMed
23.
Zurück zum Zitat Nwoye UO, Chaudhry QL, Mercer DF, Wendy GJ, Botha J, Langnas AN (2010) Experience of intestinal transplantation for total intestinal aganglionosis in children. Am J Transplant 4:379 Nwoye UO, Chaudhry QL, Mercer DF, Wendy GJ, Botha J, Langnas AN (2010) Experience of intestinal transplantation for total intestinal aganglionosis in children. Am J Transplant 4:379
24.
25.
Zurück zum Zitat Chardot C, Irtan S, Dupic L, Telion C, Moulin F, Zahar J, Canioni D, Lambot K, Charbit M, Boutemy A, Talbotec C, Colomb V, Goulet O, Aigrain Y, Revillon Y, Lacaille F (2011) Evolution of intestinal transplantation–multivisceral transplantation. JPGN 52:1 Chardot C, Irtan S, Dupic L, Telion C, Moulin F, Zahar J, Canioni D, Lambot K, Charbit M, Boutemy A, Talbotec C, Colomb V, Goulet O, Aigrain Y, Revillon Y, Lacaille F (2011) Evolution of intestinal transplantation–multivisceral transplantation. JPGN 52:1
26.
Zurück zum Zitat Sharif K, Beath SV, Kelly DA, McKiernan P, van Mourik I, Mirza D, Mayer AD, Buckels JA, de Ville de Goyet J (2003) New perspective for the management of near-total or total intestinal aganglionosis in infants. J Pediatr Surg 38(1):25–28. doi:10.1053/jpsu.2003.50004 (discussion 25–28) CrossRefPubMed Sharif K, Beath SV, Kelly DA, McKiernan P, van Mourik I, Mirza D, Mayer AD, Buckels JA, de Ville de Goyet J (2003) New perspective for the management of near-total or total intestinal aganglionosis in infants. J Pediatr Surg 38(1):25–28. doi:10.​1053/​jpsu.​2003.​50004 (discussion 25–28) CrossRefPubMed
27.
28.
Zurück zum Zitat Varkey J, Simren M, Jalanko H, Oltean M, Saalman R, Gudjonsdottir A, Gabel M, Borg H, Edenholm M, Bentdal O, Husby S, Staun M, Makisalo H, Bosaeus I, Olausson M, Pakarinen M, Herlenius G (2015) Fifteen years’ experience of intestinal and multivisceral transplantation in the Nordic countries. Scand J Gastroenterol 50(3):278–290. doi:10.3109/00365521.2014.999255 CrossRefPubMed Varkey J, Simren M, Jalanko H, Oltean M, Saalman R, Gudjonsdottir A, Gabel M, Borg H, Edenholm M, Bentdal O, Husby S, Staun M, Makisalo H, Bosaeus I, Olausson M, Pakarinen M, Herlenius G (2015) Fifteen years’ experience of intestinal and multivisceral transplantation in the Nordic countries. Scand J Gastroenterol 50(3):278–290. doi:10.​3109/​00365521.​2014.​999255 CrossRefPubMed
30.
Zurück zum Zitat Ganousse-Mazeron S, Lacaille F, Colomb-Jung V, Talbotec C, Ruemmele F, Sauvat F, Chardot C, Canioni D, Jan D, Revillon Y, Goulet O (2015) Assessment and outcome of children with intestinal failure referred for intestinal transplantation. Clin Nutr 34(3):428–435. doi:10.1016/j.clnu.2014.04.015 CrossRefPubMed Ganousse-Mazeron S, Lacaille F, Colomb-Jung V, Talbotec C, Ruemmele F, Sauvat F, Chardot C, Canioni D, Jan D, Revillon Y, Goulet O (2015) Assessment and outcome of children with intestinal failure referred for intestinal transplantation. Clin Nutr 34(3):428–435. doi:10.​1016/​j.​clnu.​2014.​04.​015 CrossRefPubMed
32.
33.
Zurück zum Zitat Ramisch D, Rumbo C, Echevarria C, Moulin L, Niveyro S, Orce G, Crivelli A, Martinez MI, Chavez L, Paez MA, Trentadue J, Klein F, Fernandez A, Solar H, Gondolesi GE (2016) Long-term outcomes of intestinal and multivisceral transplantation at a single center in Argentina. Transplant Proc 48(2):457–462. doi:10.1016/j.transproceed.2015.12.066 CrossRefPubMed Ramisch D, Rumbo C, Echevarria C, Moulin L, Niveyro S, Orce G, Crivelli A, Martinez MI, Chavez L, Paez MA, Trentadue J, Klein F, Fernandez A, Solar H, Gondolesi GE (2016) Long-term outcomes of intestinal and multivisceral transplantation at a single center in Argentina. Transplant Proc 48(2):457–462. doi:10.​1016/​j.​transproceed.​2015.​12.​066 CrossRefPubMed
35.
Zurück zum Zitat Puri P (2011) Hirschsprung’s disease. In: Puri P (ed) Newborn surgery, 3rd edn. Hodder Arnold, London, pp 554–565CrossRef Puri P (2011) Hirschsprung’s disease. In: Puri P (ed) Newborn surgery, 3rd edn. Hodder Arnold, London, pp 554–565CrossRef
37.
Zurück zum Zitat Guarino A, De Marco G, Italian National Network for Pediatric Intestinal F (2003) Natural history of intestinal failure, investigated through a national network-based approach. J Pediatr Gastroenterol Nutr 37(2):136–141CrossRefPubMed Guarino A, De Marco G, Italian National Network for Pediatric Intestinal F (2003) Natural history of intestinal failure, investigated through a national network-based approach. J Pediatr Gastroenterol Nutr 37(2):136–141CrossRefPubMed
41.
Zurück zum Zitat El Kasmi KC, Anderson AL, Devereaux MW, Fillon SA, Harris JK, Lovell MA, Finegold MJ, Sokol RJ (2012) Toll-like receptor 4-dependent Kupffer cell activation and liver injury in a novel mouse model of parenteral nutrition and intestinal injury. Hepatology 55(5):1518–1528. doi:10.1002/hep.25500 CrossRefPubMedPubMedCentral El Kasmi KC, Anderson AL, Devereaux MW, Fillon SA, Harris JK, Lovell MA, Finegold MJ, Sokol RJ (2012) Toll-like receptor 4-dependent Kupffer cell activation and liver injury in a novel mouse model of parenteral nutrition and intestinal injury. Hepatology 55(5):1518–1528. doi:10.​1002/​hep.​25500 CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Kaufman SS (2001) Small bowel transplantation: selection criteria, operative techniques, advances in specific immunosuppression, prognosis. Curr Opin Pediatr 13(5):425–428CrossRefPubMed Kaufman SS (2001) Small bowel transplantation: selection criteria, operative techniques, advances in specific immunosuppression, prognosis. Curr Opin Pediatr 13(5):425–428CrossRefPubMed
43.
Zurück zum Zitat Fishbein TM, Florman S, Gondolesi G, Schiano T, LeLeiko N, Tschernia A, Kaufman S (2002) Intestinal transplantation before and after the introduction of sirolimus. Transplantation 73(10):1538–1542CrossRefPubMed Fishbein TM, Florman S, Gondolesi G, Schiano T, LeLeiko N, Tschernia A, Kaufman S (2002) Intestinal transplantation before and after the introduction of sirolimus. Transplantation 73(10):1538–1542CrossRefPubMed
44.
Zurück zum Zitat Pearce RJ, Pota H, Evehe MS, el Ba H, Mombo-Ngoma G, Malisa AL, Ord R, Inojosa W, Matondo A, Diallo DA, Mbacham W, van den Broek IV, Swarthout TD, Getachew A, Dejene S, Grobusch MP, Njie F, Dunyo S, Kweku M, Owusu-Agyei S, Chandramohan D, Bonnet M, Guthmann JP, Clarke S, Barnes KI, Streat E, Katokele ST, Uusiku P, Agboghoroma CO, Elegba OY, Cisse B, Ie AE, Giha HA, Kachur SP, Lynch C, Rwakimari JB, Chanda P, Hawela M, Sharp B, Naidoo I, Roper C (2009) Multiple origins and regional dispersal of resistant dhps in African Plasmodium falciparum malaria. PLoS Med 6(4):e1000055. doi:10.1371/journal.pmed.1000055 CrossRefPubMedPubMedCentral Pearce RJ, Pota H, Evehe MS, el Ba H, Mombo-Ngoma G, Malisa AL, Ord R, Inojosa W, Matondo A, Diallo DA, Mbacham W, van den Broek IV, Swarthout TD, Getachew A, Dejene S, Grobusch MP, Njie F, Dunyo S, Kweku M, Owusu-Agyei S, Chandramohan D, Bonnet M, Guthmann JP, Clarke S, Barnes KI, Streat E, Katokele ST, Uusiku P, Agboghoroma CO, Elegba OY, Cisse B, Ie AE, Giha HA, Kachur SP, Lynch C, Rwakimari JB, Chanda P, Hawela M, Sharp B, Naidoo I, Roper C (2009) Multiple origins and regional dispersal of resistant dhps in African Plasmodium falciparum malaria. PLoS Med 6(4):e1000055. doi:10.​1371/​journal.​pmed.​1000055 CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Smith JM, Skeans MA, Horslen SP, Edwards EB, Harper AM, Snyder JJ, Israni AK, Kasiske BL (2017) OPTN/SRTR 2015 annual data report: intestine. Am J Transplant 17(Suppl 1):252–285. doi:10.1111/ajt.14127 CrossRefPubMed Smith JM, Skeans MA, Horslen SP, Edwards EB, Harper AM, Snyder JJ, Israni AK, Kasiske BL (2017) OPTN/SRTR 2015 annual data report: intestine. Am J Transplant 17(Suppl 1):252–285. doi:10.​1111/​ajt.​14127 CrossRefPubMed
46.
Zurück zum Zitat Abu-Elmagd KM, Costa G, Bond GJ, Soltys K, Sindhi R, Wu T, Koritsky DA, Schuster B, Martin L, Cruz RJ, Murase N, Zeevi A, Irish W, Ayyash MO, Matarese L, Humar A, Mazariegos G (2009) Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challenges. Ann Surg 250(4):567–581. doi:10.1097/SLA.0b013e3181b67725 PubMed Abu-Elmagd KM, Costa G, Bond GJ, Soltys K, Sindhi R, Wu T, Koritsky DA, Schuster B, Martin L, Cruz RJ, Murase N, Zeevi A, Irish W, Ayyash MO, Matarese L, Humar A, Mazariegos G (2009) Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challenges. Ann Surg 250(4):567–581. doi:10.​1097/​SLA.​0b013e3181b67725​ PubMed
47.
Zurück zum Zitat Abu-Elmagd KM, Costa G, Bond GJ, Wu T, Murase N, Zeevi A, Simmons R, Soltys K, Sindhi R, Stein W, Demetris A, Mazariegos G (2009) Evolution of the immunosuppressive strategies for the intestinal and multivisceral recipients with special reference to allograft immunity and achievement of partial tolerance. Transpl Int 22(1):96–109. doi:10.1111/j.1432-2277.2008.00785.x CrossRefPubMed Abu-Elmagd KM, Costa G, Bond GJ, Wu T, Murase N, Zeevi A, Simmons R, Soltys K, Sindhi R, Stein W, Demetris A, Mazariegos G (2009) Evolution of the immunosuppressive strategies for the intestinal and multivisceral recipients with special reference to allograft immunity and achievement of partial tolerance. Transpl Int 22(1):96–109. doi:10.​1111/​j.​1432-2277.​2008.​00785.​x CrossRefPubMed
Metadaten
Titel
A meta-analysis of clinical outcome of intestinal transplantation in patients with total intestinal aganglionosis
verfasst von
Hiroki Nakamura
Davina Henderson
Prem Puri
Publikationsdatum
09.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 8/2017
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4107-2

Weitere Artikel der Ausgabe 8/2017

Pediatric Surgery International 8/2017 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.