Disaccharidase activities and fat assimilation in pediatric XXXX after intestinal transplantation.

@entity1 @entity290 @entity270 @entity5277 @entity942
BACKGROUND: Intestinal transplantation has become an accepted therapy for @entity5277 and other types of intestinal failure. In order to assess digestive capabilities and feeding practices in a group of 22 pediatric @entity1 after intestinal transplantation, we assessed mucosal disaccharidase activities and assimilation of total dietary lipid and @entity270 . Twelve of the @entity1 had undergone contemporaneous liver transplantation. METHODS: Mucosal biopsies were assayed for disaccharidase activities between 15 and 412 days after transplantation in 7 of the 22 when all were receiving some enteral nutrition and were free of rejection. Coefficients of lipid absorption were determined in those @entity1 receiving total enteral feeding (two-thirds polymeric/one-third elemental) between 43 and 1032 days after transplantation; oral @entity270 tolerance tests were done at about the same time. RESULTS: Activities of @entity290 , sucrase, maltase, and palatinase consistently exceeded reference ranges (P<0.05). Mean coefficient of lipid absorption equaled 86+/-12% and was not influenced by duration of time after transplantation. No @entity1 required dietary lipid restriction. No significant absorption of @entity270 was demonstrated until 160 days after transplantation. @entity270 absorption did correlate with length of time elapsed after surgery (r=0.64, P<0.0011). CONCLUSIONS: The results of this investigation show that, in the absence of histologic or clinical indications of allograft rejection, pediatric intestinal transplant recipients do not have primary @entity942 . Similarly, absorption of usual dietary lipid content is adequate once weaning from parenteral nutrition is complete. In contrast, early assimilation of @entity270 is poor. @entity270 absorption subsequently improves, but the mechanism is obscure.
