Pediatric liver transplantation: preliminary results at Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione.

Between July 2003 and November 2004 14 pediatric liver transplantations (LTx) have been performed in 12 children using cadaveric donors. The primary diseases were as follows biliary atresia in 9 cases, whereas the other 3 children were affected by cystic fibrosis, Langherans cells histiocytosis, and hepatoblastoma, respectively. Median patient waiting time was 103 days (range, 2-158); no patient died while on the waiting list.

Changes in serum electrolytes during treatment of patients in liver failure with molecular adsorbent recirculating system.

Purpose: To study the effect of MARS on serum electrolytes during liver failure.

Design: Twenty-three patients admitted to a quaternary health care facility from September 2000 to May 2002, 22 adults and 1 child, 11 males (48%) and 12 females (52%), age 15-70 (median 53), treated with MARS for: 12 acute-on-chronic liver failure (52%); 4 fulminant hepatic failure (17%); 3 intractable pruritus (13%); 2 primary-non-function (9%); 2 following major liver resection (9%).

Procedures: Sodium, potassium, chloride, phosphorus, calcium, and magnesium were measured in the serum, ultrafiltrate and albumin circuit before and after MARS.

[Short bowel syndrome: etiologic, pathogenetic aspects and principles of treatment].

A significant problem in surgery following massive intestinal resection is the short bowel syndrome characterized by severe fluid and electrolyte loss, watery diarrhoea and malnutrition. Total parenteral nutrition and enteral nutrition are essential in the clinical course of the syndrome; their use for prolonged periods results in the gradual intestinal adaptation and greater absorptive and reservoir capacities of the intestinal remnant. Adjunctive surgery can slow rapid intestinal transit and induce growth of neo-small-bowel mucosa but is not recommended for routine use.