Abstract
During the past 11 years from 1983 to 1993 we experienced 14 patients with intestinal failure in our division, and clinical analysis was done on these 14 patients whether they had an indication of intestinal transplantation. Of the 14 patients 3 were short bowel syndrome, 4 extensive aganglionosis, 2 hypoganglionosis, 3 immature ganglionosis, 1 chronic idiopathic intestinal pseudo-obstruction, and 1 megacystis-microcolon-intestinal-hypoperistalsis syndrome. Three patients with short bowel syndrome were managed only by total parenteral nutrition. However, they died within 8 months after birth. Three of the 4 patients with extensive aganglionosis, who had ganglionic small intestine less than 5 cm could not get free from total parenteral nutrition and two died. However, another patient with extensive aganglionosis with 145cm ganglionic small intestine achieved full enteral nutrition. One of the 2 with hypoganglionosis died from sepsis, and another need intestinal irrigations every day despite full enteral nutrition. In one patient with chronic idiopathic intestinal pseudo-obstruction elemental diet was given, but she had severe abdominal distention and sometimes suffered from enterites. One patient with megacystis-microcolon-intestinal-hypoperistalsis syndrome is now on total parenteral nutrition. All of the 3 patients with immature ganglionosis achieved full enteral nutrition. In conclusion, those patients who can not get free from total parenteral nutrition or who have high risk of enteritis because of intestinal pseudo-obstruction should be considered as having an indication of intestinal transplantation.
