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Research Update in Pediatric Intestinal Failure, Rehabilitation, and Transplant

April 7, 2021

Teams of UPMC Children's Hospital of Pittsburgh Division of Pediatric Gastroenterology, Hepatology, and Nutrition published three new papers in March and April in the Journal of Pediatric Gastroenterology and Nutrition.

The first study,1 “Caregiver Decision-Making in Pediatric Intestinal Failure: A Qualitative Study Focused on Iron Deficiency Anemia,” was led by Division fellow and incoming faculty member Vikram K. Raghu, MD, MS. The study involved interviews with caregivers of children with intestinal failure to better understand their decision-making perspectives regarding anemia treatment in intestinal failure.

In the April edition of the Journal of Pediatric Gastroenterology and Nutrition, faculty from the Division’s Intestinal Care and Rehabilitation Center (ICARE) published findings2 on the treatment and outcomes of patients with megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS). The study is the largest single-center case series on MMIHS patients to date. The retrospective analysis examined cases (n=25) over a 17-year period, finding that MMIHS patients had notably good outcomes relative to long-term survival, growth, and liver function. Former division fellow Krishnapriya M. Prathapan, MD, was the lead author of the study. Feras Alissa, MD, and Jeffrey A. Rudolph, MD, Division clinical director and director of  UPMC Children’s ICARE were senior authors of the study. Full details and findings can be found at the below reference.

Additionally, Division clinical director Jeffrey Rudolph, MD, and fellow Vikram K. Raghu, MD, MS, were coauthors of a new position paper3 from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) detailing best practices for the management of central venous access (CVA) in children with intestinal failure. The extensive paper reviews the current evidence-based approaches to central-line management with recommendations for optimizing care and reducing complication rates and the risk of adverse events. The full text of the position paper is currently available for review and download at the Journal's website.

References

1. Raghu VK, Prathapan KM, Hamm ME, Rudolph JA, Norman MK. Caregiver Decision-Making in Pediatric Intestinal Failure: A Qualitative Study Focused on Iron Deficiency Anemia. J Pediatr Gastroenterol Nutr. 2021 Mar 1; 72(3): 446-450.

2. Prathapan KM, King DE, Raghu VK, Ackerman K, Presel T, Yaworski JA, Ganoza A, Bond G, Sevilla WMA, Rudolph JA, Alissa F. Megacystis Microcolon Intestinal Hypoperistalis Syndrome: A Case Series With Long-Term Follow-Up and Prolonged Survival. J Pediatr Gastroenterol Nutr. 2021 Apr 1; 72(4): e81-e85.

3. Wendel D, Mezoff EA, Raghu VK, Kinberg S, Soden J, Avitzur Y Rudolph JA, Gniadek M, Cohran VC, Venick RS, Cole CR. Management of Central Venous Access in Children With Intestinal Failure: A Position Paper From the NASPGHAN Intestinal Rehabilitation Special Interest Group. J Pediatr Gastroenterol Nutr. 2021 Mar 1; 72(3): 474-486.