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Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?

Infants with intestinal failure associated liver disease (IFALD) requiring liver and bowel transplant have a high mortality on the transplant waiting list due to the scarcity of the size-matched donor organs. Bridging liver transplantation has been used to allow the children to grow to a reasonable...

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Autores principales: Sharif, Abubakar, Sharif, Khalid, Mirza, Darius F., Gupte, Girish L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139533/
https://www.ncbi.nlm.nih.gov/pubmed/35626876
http://dx.doi.org/10.3390/children9050699
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author Sharif, Abubakar
Sharif, Khalid
Mirza, Darius F.
Gupte, Girish L.
author_facet Sharif, Abubakar
Sharif, Khalid
Mirza, Darius F.
Gupte, Girish L.
author_sort Sharif, Abubakar
collection PubMed
description Infants with intestinal failure associated liver disease (IFALD) requiring liver and bowel transplant have a high mortality on the transplant waiting list due to the scarcity of the size-matched donor organs. Bridging liver transplantation has been used to allow the children to grow to a reasonable size so that a combined liver and small bowel transplant could be performed in the future. We report on two children with irreversible intestinal failure (ultra-short bowel syndrome secondary to gastroschisis and microvillous inclusion disease) with IFALD who underwent bridging liver transplantation at our institution. Both patients made a good recovery from their initial surgery. One patient died 6 months following surgery from generalized sepsis, and the other patient survived in good condition to undergo a combined liver and small bowel transplant but died a few days post-transplant. In the current era of scarcity of donor organs, this raises an ethical dilemma for the team involved regarding appropriate utilisation of a scarce resource.
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spelling pubmed-91395332022-05-28 Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far? Sharif, Abubakar Sharif, Khalid Mirza, Darius F. Gupte, Girish L. Children (Basel) Article Infants with intestinal failure associated liver disease (IFALD) requiring liver and bowel transplant have a high mortality on the transplant waiting list due to the scarcity of the size-matched donor organs. Bridging liver transplantation has been used to allow the children to grow to a reasonable size so that a combined liver and small bowel transplant could be performed in the future. We report on two children with irreversible intestinal failure (ultra-short bowel syndrome secondary to gastroschisis and microvillous inclusion disease) with IFALD who underwent bridging liver transplantation at our institution. Both patients made a good recovery from their initial surgery. One patient died 6 months following surgery from generalized sepsis, and the other patient survived in good condition to undergo a combined liver and small bowel transplant but died a few days post-transplant. In the current era of scarcity of donor organs, this raises an ethical dilemma for the team involved regarding appropriate utilisation of a scarce resource. MDPI 2022-05-10 /pmc/articles/PMC9139533/ /pubmed/35626876 http://dx.doi.org/10.3390/children9050699 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sharif, Abubakar
Sharif, Khalid
Mirza, Darius F.
Gupte, Girish L.
Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title_full Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title_fullStr Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title_full_unstemmed Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title_short Bridging Liver Transplantation in the Treatment of Intestinal Failure Associated Liver Disease in Infants—A Bridge Too Far?
title_sort bridging liver transplantation in the treatment of intestinal failure associated liver disease in infants—a bridge too far?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139533/
https://www.ncbi.nlm.nih.gov/pubmed/35626876
http://dx.doi.org/10.3390/children9050699
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