Epidemiology of candidacy for intestinal transplantation and timing for referral are unknown.
Dr Loris Pironi and colleagues from Italy investigated patient candidacy and physician attitudes toward intestinal transplantation.
The team of doctors included centers that participated in previous European surveys on home parenteral nutrition.
Patients on home parenteral nutrition for benign intestinal failure were evaluated by a structured questionnaire.
Candidacy was assessed by USA Medicare and American Transplantation Society criteria.
|Candidacy was 16% in adults and 34% in pediatrics|
|American Journal of Gastroenterology|
Candidacy was categorized as life-threatening home parenteral nutrition complications, high risk of death because of gastrointestinal disease, and high morbidity.
Physicians judged candidacy as immediate or potential.
The team enrolled 41 centers from 9 countries enrolled 688 adults, and 166 pediatric patients.
The team reported that 70% of patients were from 5 countries which collected 60% to 100% of their home parenteral nutrition patients.
Candidacy was 16% in adults and 34% in pediatrics.
The team noted that immediate candidacy was required for 15% of adult and 16% of pediatric candidates.
Among centers, the candidacy rate ranged 0% to 100% and was negatively associated with the number of patients enrolled in the survey.
The doctors found that candidacy ranged from 0.3 to 0.8 per million inhabitants for adults.
For pediatric inhabitants, candidacy ranged home parenteral nutrition from 0.9 to 2 per million inhabitants.
Dr Pironi's team concluded, “The rate of candidacy and the indications for intestinal transplantation candidacy differed greatly among age groups and home parenteral nutrition centers.”
“Within countries candidacy was more homogeneous, and physicians had a generally reserved attitude toward intestinal transplantation.”