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  • 1
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 15 (1989), S. S76 
    ISSN: 1432-1238
    Keywords: Organ transplantation ; Kidney transplantation ; Heart transplantation ; Heart and lung transplantation ; Liver transplantation ; Small intestine transplantation ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Organ transplantations have opened a new field in medicine and particularly in pediatrics. The kidney was the first organ to be regularly transplanted and there are now more than 2000 children who have received a kidney graft. Cadaver kidneys or living-related donor (LRD) kidneys can be used since an adult kidney may be grafted in a young child. Cadaver graft survival exceeds 85% at 1 year in recent single centre reports and patient survival is above 95%, the results being even better with LRD. Some complications may be observed in the long term, such as bone osteonecrosis, hypertension or infections. Rehabilitation is generally remarkable and growth which remained abnormal in 1/3 of cases under conventional treatment seems to improve markedly with cyclosporin. In the future, the development of kidney transplantation could lead hopefully to a drastic decrease in the number of children on dialysis. Liver transplantation is now performed in children with biliary atresia and metabolic diseases. There is no age limit for grafting a liver, the only problem being to find a pediatric cadaver donor of similar size. It is also possible to use an adult liver after hepatectomy. There were 170 liver grafts recorded in children in Europe in December 1986, and the long-term survival thanks to cyclosporin is exceeding 80% in some units. Thanks to cyclosporin, programs of cardiac transplantation for children are rapidly developing. The main indications are gross-congenital cardiac malformations or severe functional abnormality not compatible with life. Newborns have been grafted with success. The only problem is also to find a suitable pediatric donor. At the end of 1984, there were 88 cadaver transplantations reported in children, and this number is growing rapidly. Survival is estimated above 70% at 1 year. Indications for heart and lung transplantation are more numerous than for the heart alone, including severe cardiac malformations with abnormality of pulmonary circulation and a number of pulmonary diseases. A close similarity in the size of donor and recipient is mandatory. The immediate results are generally good, but the final outcome remains under evaluation. First investigated in animals, small intestine transplantation has been added recently to the list of possible organ transplantations in children. Indications are extensive intestinal resections, or malformations. The initial results are encouraging, but the long-term outcome remains under evaluation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2568
    Keywords: CHRONIC INTESTINAL PSEUDOOBSTRUCTION ; CHILDREN ; SURGERY ; NUTRITIONAL SUPPORT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our aim was to collect a large number of casesto characterize clinical presentation, outcome, andprognosis of chronic intestinal pseusoobstruction inchildren. We conducted a retrospective multicenter study that included children treated forchronic intestinal pseusoobstruction defined asrecurrent episodes of intestinal obstruction with nomechanical obstruction, excluding Hirschsprung'sdisease. In all, 105 children, 57 boys and 48 girls, werestudied, including five familial forms. Prenataldiagnosis was made in 18 patients. Eighty patients wereless than 12 months old at onset; the disease began at birth for 37 patients. The most frequentsigns were abdominal distension, vomiting, andconstipation. Megacystis was noted in myopathies (7cases), neuropathies (10 cases) and unclassified forms(13 cases). For all but three cases (two patientswith CMV infection, one with Munchhausen-by-proxysyndrome), the associated diseases and disorders couldnot account for chronic intestinal pseusoobstruction as a secondary disorder. At least onefull-thickness biopsy from the digestive tract wasstudied for 99 patients. The diagnosis recorded wasvisceral neuropathy in 58 cases, visceral myopathy in 17cases, and uncertain or normal biopsy results in 24cases. Seventy-eight children were fed intravenously,and only 18 were able to be fed orally throughout theirillness. Seventy-one patients underwent surgery during their illness, and 217 surgicalprocedures, a mean of 3 per patient, were performed.Ostomy was the most performed procedure. Follow-upcontinued in 89 patients for 3 months to 16 years (mean85 months). Forty-two patients were still fed byparenteral (39 patients) or enteral nutrition (3patients) at the time of the study. Eleven patients diedbetween the age of 1 month and 14 years 7months.
    Type of Medium: Electronic Resource
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