Intestinal absorption rate in children after small intestinal transplantation.

The American journal of clinical nutrition 2013 Apr

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Small bowel transplantation has now become a recognized treatment of irreversible, permanent, and subtotal intestinal failure. The aim of this study was to assess intestinal absorption at the time of weaning from parenteral nutrition in a series of children after intestinal transplantation. Twenty-four children (age range: 14-115 mo) received intestinal transplantation, together with the liver in 6 children and the colon in 16 children. Parenteral nutrition was slowly tapered while increasing enteral tube feeding. The absorption rate was measured from a 3-d stool balance analysis performed a few days after the child had weaned from parenteral nutrition to exclusive enteral tube feeding. Results were analyzed according to the resting energy expenditure (REE; Schofield formula). All children were weaned from parenteral nutrition between 31 and 85 d posttransplantation. Median intakes were as follows: energy, 107 kcal · kg(-1) · d(-1) (range: 79-168 kcal · kg(-1) · d(-1)); lipids, 39 kcal · kg(-1) · d(-1) (range: 20-70 kcal · kg(-1) · d(-1)); and nitrogen, 17 kcal · kg(-1) · d(-1) (range: 11-27 kcal · kg(-1) · d(-1)). Median daily stool output was 998 mL/d (range: 220-2025 mL/d). Median absorption rates were 88% (range: 75-96%) for energy, 82% (range: 55-98%) for lipids, and 77% (range: 61-88%) for nitrogen. The ratios for ingested energy to REE and absorbed energy to REE were 2.2 (range: 1.6-3.6) and 1.8 (range: 1.3-3.3), respectively. These data indicate a suboptimal intestinal graft absorption capacity with fat malabsorption, which necessitates energy intakes of at least twice the REE.

Citation

Felipe Ordonez, Laurence Barbot-Trystram, Florence Lacaille, Christophe Chardot, Solène Ganousse, Laetitia Marie Petit, Virginie Colomb-Jung, Emmeline Dalodier, Julie Salomon, Cécile Talbotec, Angelo Campanozzi, Frank Ruemmele, Yann Révillon, Frédérique Sauvat, Nathalie Kapel, Olivier Goulet. Intestinal absorption rate in children after small intestinal transplantation. The American journal of clinical nutrition. 2013 Apr;97(4):743-9