Nutrition support in the pediatric total pancreatectomy with islet autotransplantation recipient

• Published in: Nutrition in clinical practice Vol. 39; no. 1; pp. 100 - 108
• Main Authors: Downs, Elissa M., Brun, Amanda, Bellin, Melena D.
• Format: Journal Article
• Language: English
• Published: United States 01.02.2024
• Subjects: Child; enteral formulas; enteral nutrition; gastroenterology; Humans; Islets of Langerhans Transplantation; minerals/trace elements; nutrition assessment; Pancreatectomy - adverse effects; pancreatic disease; Pancreatitis, Chronic - complications; Pancreatitis, Chronic - surgery; pediatrics; Quality of Life; Transplantation, Autologous; Treatment Outcome; vitamins; enteral nutrition; minerals/trace elements; nutrition assessment; vitamins; enteral formulas; pediatrics; gastroenterology; pancreatic disease
• ISSN: 0884-5336; 1941-2452
• DOI: 10.1002/ncp.11101

For children with diminished quality of life and chronic pain caused by acute recurrent or chronic pancreatitis who are undergoing total pancreatectomy with islet autotransplantation, postoperative nutrition support has several unique characteristics. Surgical complications may lead to delays in nutrition support initiation or require modifications to the regimen. Early postoperative dysmotility requires the use of temporary enteral nutrition until this improves. The resultant complete exocrine pancreatic insufficiency necessitates lifelong pancreatic enzyme replacement therapy and fat‐soluble vitamin supplementation. A low‐oxalate diet is recommended to prevent kidney stones. Carbohydrate counting is needed for the provision of short‐term insulin dosing and possibly long‐term as well, depending on the transplanted islet yield. Children should have careful nutrition assessment and monitoring at several follow‐up visits during the first year, then annually, and at any time with concerns.