Management of end-stage central venous access in children referred for possible small bowel transplantation

Journal of Pediatric Gastroenterology and Nutrition
A F RodriguesS V Beath

Abstract

The 3-year survival after small bowel transplantation (SBTx) has improved to between 73% and 88%. Impaired venous access for parenteral nutrition can be an indication for SBTx in children with chronic intestinal failure. To report our experience in management of children with extreme end-stage venous access. The study consisted of 6 children (all boys), median age of assessment 27 months (range, 13-52 months), diagnosed with total intestinal aganglionosis (1), protracted diarrhea (1), and short bowel syndrome (4), of which gastroschisis (2) and malrotation with midgut volvulus (2) were the causes. All had a documented history of more than 10 central venous catheter insertions previously. All had venograms, and 1 child additionally had a magnetic resonance angiogram to evaluate venous access. Five of 6 presented with thrombosis of the superior vena cava (SVC) and/or inferior vena cava. Venous access was reestablished as follows: transhepatic venous catheters (5), direct intra-atrial catheter via midline sternotomy (4), azygous venous catheters (2), dilatation of left subclavian vein after passage of a guide wire and then placing a catheter to reach the right atrium (1), radiological recanalization of the SVC and placement of a c...Continue Reading

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Citations

Sep 28, 2007·Current Treatment Options in Gastroenterology·Frances R Malone, Simon P Horslen
Mar 1, 2012·British Journal of Anaesthesia·T MatsusakiS Aggarwal
Mar 5, 2016·Journal of Pediatric Surgery·Jessica Gonzalez-HernandezHannah G Piper
Mar 4, 2014·Journal of Vascular and Interventional Radiology : JVIR·Kevin M BaskinCharles R Fitz
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Dec 12, 2012·Journal of Pediatric Surgery·Antonella DiamantiJean de Ville de Goyet
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Feb 4, 2010·Seminars in Pediatric Surgery·Jason S Soden
Jul 22, 2008·Journal of Pediatric Surgery·Aayed R Alqahtani
Jun 19, 2008·Journal of Pediatric Surgery·Anthony S de Buys RoessinghJean-Marc Joseph
Feb 26, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J E Sola, W R Thompson
Apr 16, 2016·Early Human Development·Kelsey D J Jones, Lucy J Howarth
Feb 14, 2020·Pediatrics International : Official Journal of the Japan Pediatric Society·Tomoya HaradaMasato Kusunoki
Mar 24, 2017·JPEN. Journal of Parenteral and Enteral Nutrition·Patricia WorthingtonBeverly Holcombe
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Apr 17, 2021·Current Gastroenterology Reports·Danielle WendelValeria C Cohran

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