2011 - ISBTS 2011 Symposium
Oral Communications 3: Nutrition Outcomes
5.120 - Absorption after intestinal transplantation
Presenter: Florence, Lacaille, Paris, France
Authors: Felipe Ordonez1, Florence Lacaille1, Olivier Goulet1
Absorption after intestinal transplantation
Felipe Ordonez, Florence Lacaille, Olivier Goulet
Pediatric Hepatogastroenterology-Nutrition, Hôpital Necker-Enfants malades, Paris, France, Metropolitan
Aim: To describe the functional capacity of intestinal allograft, with an analysis of intestinal absorption rate of children after ITx at the time of PN weaning.
Methods: 18 children (1.5 to 10 years) received ITx, with liver in 2 cases and colon in 14 cases, using tacrolimus, steroids and IL-2 blockers. Small bowel graft was put as an ileostomy. PN was tapered as enteral tube feeding (ETF) progressed according to digestive tolerance (stool output) and body weight gain. ETF was based on semi-elemental diet containing 50% energy as lipid with 50% medium chain triglycerides. A few days after PN weaning, intestinal absorption assessment was performed by using 3 days stool balance analysis. Fat, nitrogen, and total energy content were determined by the method of van de Kamer, elemental nitrogen analysis, and bomb calorimetry, respectively. Results were analysed according to the resting energy expenditure (REE) calculated from Schofield formula.
Results: All children were weaned from PN while on full ETF after 31 to 83 days post Tx (median : 44). Median daily stool output at time of analysis was 1137 ml/day (range: 314-2025 ml/day). Median intakes were: energy 108 kcal/kg/day (range: 79-162 kcal/kg/day), lipid 37.5 kcal/kg/day (range: 20-57.5 kcal/kg/day) and nitrogen 18.0 kcal/kg/day (range: 12.7-27.0 kcal/kg/day). The median absorption rates were 85% (range: 75-95%) for energy, 79% (range: 54.5-92.3%) for lipid and 75% (range: 61.5-88%) for nitrogen. The ratio ingested energy/REE and absorbed energy/REE were 2.1 (range: 1.73-3.06) and 1.84 (range: 1.47-2.92), respectively.
Conclusion: PN weaning with appropriate weight gain may be achieved within 1 to 3 months after ITx. The ratios ingested energy/REE and absorbed energy/REE indicate a suboptimal graft absorption rates requiring an energy intake ≥ 2xREE. Energy and nitrogen supplies must be increased and adapted according to the digestive tolerance and to the body weight gain.
You must be logged in to view recordings
By viewing the material on this site you understand and accept that:
- The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
- The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
- The material is solely for educational purposes for qualified health care professionals.
- The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
- The information cannot be used as a substitute for professional care.
- The information does not represent a standard of care.
- No physician-patient relationship is being established.