{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:54:31Z","timestamp":1761630871040},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Temporary ileostomy during intestinal transplantation (ITx) is the standard technique for allograft monitoring. A detailed analysis of the ITx ileostomy has never been reported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>A retrospective review of a single-center ITx database was performed. The analysis was divided into ileostomy formation and takedown episodes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>One hundred thirty-five grafts underwent ileostomy formation, and 79 underwent ileostomy takedown. Median age at ITx was 7.7 years and weight was 23 kg. Allograft types were intestine (22%), liver\/intestine (55%), multivisceral (16%), and modified multivisceral (7%). Sixty-four percent had 1-stage ITx, whereas 36% required 2-staged ITx. Final ileostomy types were end (20%), loop (10%), distal blowhole (59%), and proximal blowhole (11%). Ileostomy formation: Thirty-one grafts had complications (23%), including prolapse (26%), ischemia (16%), and parastomal hernia (19%). Twelve required surgical revision. There were no significant differences in graft type, ileostomy type, survival, and ileostomy takedown rate between grafts with and without complications. Colon inclusive grafts had higher complication rates (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002). Ileostomy takedown: Ileostomy takedown occurred at a median of 422 days post-ITx. Twenty-five complications occurred after 22 takedowns (28%), including small bowel obstruction (27%) and abscess (18%). Fifteen grafts required surgical correction. Recipients with complications had longer hospital stay (17 versus 9 d; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001) than those without complications. Graft type, ileostomy type, and survival were not different.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>The first of its kind analysis of the surgical ileostomy after ITx reveals that most recipients can undergo successful ileostomy formation\/takedown, complication rates are significant but within an acceptable range, and complications do not affect survival. This study demonstrates that the routine use of transplant ostomies remains an acceptable practice after ITx. However, true analysis of risk and benefit will require a randomized control trial.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000002879","type":"journal-article","created":{"date-parts":[[2019,7,21]],"date-time":"2019-07-21T21:36:31Z","timestamp":1563744991000},"page":"652-658","source":"Crossref","is-referenced-by-count":7,"title":["Ileostomy After Intestinal Transplantation: The First in Depth Report on Techniques, Complications, and Outcomes"],"prefix":"10.1097","volume":"104","author":[{"given":"Wethit","family":"Dumronggittigule","sequence":"first","affiliation":[{"name":"The Dumont UCLA Transplant Center, Division of Liver and Pancreas transplantation, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."},{"name":"Hepato-Pancreato-Biliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Venick","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mattel Children\u2019s Hospital, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. John","family":"Dubray","sequence":"additional","affiliation":[{"name":"The Dumont UCLA Transplant Center, Division of Liver and Pancreas transplantation, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine C.","family":"Cheng","sequence":"additional","affiliation":[{"name":"The Dumont UCLA Transplant Center, Division of Liver and Pancreas transplantation, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Duffy","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Abdominal Transplant Program, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Marcus","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Mattel Children\u2019s Hospital, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."},{"name":"VA Greater Los Angeles Health Care System, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald W.","family":"Busuttil","sequence":"additional","affiliation":[{"name":"The Dumont UCLA Transplant Center, Division of Liver and Pancreas transplantation, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas G.","family":"Farmer","sequence":"additional","affiliation":[{"name":"The Dumont UCLA Transplant Center, Division of Liver and Pancreas transplantation, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20231002","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/ajt.12979","article-title":"Intestinal transplant registry report: global activity and trends.","volume":"15","author":"Grant","year":"2015","journal-title":"Am J Transplant"},{"key":"R2-20231002","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00000658-199209000-00002","article-title":"Intestinal transplantation in composite visceral grafts or alone.","volume":"216","author":"Todo","year":"1992","journal-title":"Ann Surg"},{"key":"R4-20231002","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1159\/000083471","article-title":"A prospective audit of the complications of loop ileostomy construction and takedown.","volume":"21","author":"Garc\u00eda-Botello","year":"2004","journal-title":"Dig 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sutured closure of loop ileostomy: a randomized controlled trial.","volume":"231","author":"Hasegawa","year":"2000","journal-title":"Ann Surg"},{"key":"R9-20231002","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1046\/j.1463-1318.2002.00398.x","article-title":"Safety of the temporary loop ileostomy.","volume":"4","author":"Hallb\u00f6\u00f6k","year":"2002","journal-title":"Colorectal Dis"},{"key":"R10-20231002","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1001\/archsurg.2011.234","article-title":"Loop ileostomy reversal after colon and rectal surgery: a single institutional 5-year experience in 944 patients.","volume":"146","author":"Luglio","year":"2011","journal-title":"Arch Surg"},{"key":"R11-20231002","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/codi.12029","article-title":"Closure of defunctioning loop ileostomy is associated with considerable morbidity.","volume":"15","author":"Sharma","year":"2013","journal-title":"Colorectal Dis"},{"key":"R12-20231002","first-page":"184","article-title":"Successful combined liver and small intestine transplantation for short-gut syndrome and liver failure.","volume":"158","author":"Busuttil","year":"1993","journal-title":"West J Med"},{"key":"R13-20231002","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1001\/archsurg.136.9.1027","article-title":"Outcome after intestinal transplantation: results from one center\u2019s 9-year experience; discussion 1031-2.","volume":"136","author":"Farmer","year":"2001","journal-title":"Arch Surg"},{"key":"R14-20231002","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1053\/jlts.2003.50155","article-title":"Multivisceral and isolated intestinal procurement techniques.","volume":"9","author":"Yersiz","year":"2003","journal-title":"Liver Transpl"},{"key":"R15-20231002","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.transproceed.2003.12.016","article-title":"Application of combined liver-intestinal transplantation as a staged procedure.","volume":"36","author":"Renz","year":"2004","journal-title":"Transplant Proc"},{"key":"R16-20231002","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1097\/TP.0b013e31820000a1","article-title":"Pretransplant predictors of survival after intestinal transplantation: analysis of a single-center experience of more than 100 transplants.","volume":"90","author":"Farmer","year":"2010","journal-title":"Transplantation"},{"key":"R17-20231002","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/S0140-6736(52)92149-1","article-title":"The management of an ileostomy, including its complications.","volume":"2","author":"Brooke","year":"1952","journal-title":"Lancet"},{"key":"R18-20231002","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/00000658-195703000-00017","article-title":"Management of meconium ileus; resection, roux-en-Y anastomosis and ileostomy irrigation with pancreatic enzymes.","volume":"145","author":"Bishop","year":"1957","journal-title":"Ann Surg"},{"key":"R19-20231002","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1097\/MPG.0000000000000871","article-title":"Endoscopy following pediatric intestinal transplant.","volume":"61","author":"Yeh","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R20-20231002","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00383-017-4216-y","article-title":"The challenges of closing an ileostomy in patients with total intestinal aganglionosis after small bowel transplant.","volume":"34","author":"Jazi","year":"2018","journal-title":"Pediatr Surg Int"}],"container-title":["Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/TP.0000000000002879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T05:11:02Z","timestamp":1696223462000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/TP.0000000000002879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/tp.0000000000002879","relation":{},"ISSN":["0041-1337"],"issn-type":[{"value":"0041-1337","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3]]}}}