NUTRITIONAL CARE AND CANDIDATES FOR SMALL-BOWEL TRANSPLANTATION

Twenty two children were evaluated for small bowel transplantation between 1989 and 1994. Eight were unfit for transplantation and died within three months; a raised plasma bilirubin concentration (>200 mu mol/l) predicted death from liver failure within six months (p=0.0001). The 11 children who were not managed by a multidisciplinary nutritional care team were less well nourished at referral, had more complications with intravenous feeding catheters, and greater early mortality while awaiting transplantation (p<0.05). It is recommended that children with chronic intestinal failure be referred for assessment early, before liver dysfunction is established.