Dr Andreas Tzakis and colleagues evaluated the evolution of multivisceral transplantation over a decade of experience.
Multivisceral transplantation can be valuable for the treatment of patients with massive abdominal catastrophes.
Its major limitations have been technical and rejection of the intestinal graft.
The team included 98 patients who received multivisceral transplantation in an outcome analysis, the largest single center experience to date.
The most common diseases before transplants were intestinal gastroschisis and intestinal dysmotility syndromes in children.
| Patient and graft survivals for all cases were 65% and 63% at 1 year|
|Annals of Surgery|
For adults, the most common diseases before transplants and mesenteric thrombosis and trauma in adults.
Using Kaplan Meier, the team estimated that patient and graft survivals for all cases were 65% and 63% at 1 year, and 49% and 47% at 3 years.
The team also found that patient and graft survivals were and 49% and 47% at 5 years.
The researchers noted that before 1998, being hospitalized at the time of transplant adversely influenced patient survival.
Another factor that influenced patient survival included being a child who received Campath-1H induction.
The team observed that among 37 patients who had none of these 3 factors, estimated 1- and 3-year survivals were 89% and 71%, respectively.
Patients transplanted since 2001 had significantly less moderate and severe rejections with almost half of these patients never developing rejection.
Dr Tzakis' team commented, “Multivisceral transplantation is now an effective treatment of patients with complex abdominal pathology.”
“The incidences of serious acute rejection and patient survival have improved in the most recent experience.”
“Our results show that the multivisceral graft seems to facilitate engraftment of transplanted organs and raises the possibility that there is a degree of immunologic protection afforded by this procedure.”