The intestine has been more difficult to transplant than other solid organs.
Dr Grant and colleagues analyzed registry data to determine the scope and success of intestine transplantation in the current era.
The researchers reported that all known intestinal-transplant programs participated.
Patient and graft survival estimates were obtained using the Kaplan-Meier product limit method and were analyzed with the Wilcoxon statistic.
The research team stated that 61 programs provided data on 989 grafts in 923 patients although 4 patients were lost to follow-up.
61% of the recipients were 18 years or younger.
The researchers noted that the short-gut syndrome was the most common primary indication for transplantation.
|Patient and graft survival approaches the results of liver transplantation with the immunosuppressive protocols|
|Annals of Surgery|
Proportionally more combined intestinal and liver transplants were performed in the younger age group.
The investigators found that more than 80% of all current survivors had stopped parenteral nutrition and resumed normal daily activities.
In addition, the research team conducted a multivariate analysis of cases within the last 5 years.
The multi-variate analysis revealed that transplantation of patients waiting at home, recipient age, antibody induction immune suppression, and center experience with at least 10 cases were associated with improved patient survival.
The investigative team also noted that 1 year graft survival rates of 81% were achieved in patients who were induced with antithymocyte globulin and maintained on tacrolimus.
Dr Grant concludes, “Transplantation is an effective therapy for the treatment of patients with end-stage intestine failure who cannot tolerate parenteral nutrition.”
“With newer immune suppressive protocols, 1 year graft and patient survival rates approach the results of liver transplantation.”
“Further improvement in survival are expected with early referral since suitable donor organs are scarce and survival rates are better when patients are well enough to wait at home for their transplant.”