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100 multivisceral transplants at a single center
Andreas G Tzakis1, Tomoaki Kato, David M Levi
1Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Annals of Surgery
|September 30, 2005
Summary
Multivisceral transplantation is an effective treatment for complex abdominal conditions, showing improved patient survival and reduced rejection rates in recent years. This complex procedure may offer immunologic protection, enhancing graft engraftment.
Area of Science:
- Abdominal Surgery
- Transplant Surgery
- Immunology
Background:
- Multivisceral transplantation is a valuable option for patients with massive abdominal catastrophes.
- Key challenges historically included technical complexities and graft rejection.
Purpose of the Study:
- To review the evolution and current status of multivisceral transplantation over a decade.
- To analyze outcomes from the largest single-center experience.
Main Methods:
- Outcome analysis of 98 consecutive multivisceral transplant patients.
- Kaplan-Meier survival estimates were calculated.
Main Results:
- Overall 1-year patient and graft survival rates were 65% and 63%, respectively.
- Factors like early transplant dates, hospitalization at transplant, and specific immunosuppression in children adversely affected survival.
- Patients transplanted since 2001 demonstrated significantly lower rates of moderate to severe rejection (31.6% vs. 67.6%).
Conclusions:
- Multivisceral transplantation is an effective treatment for complex abdominal pathologies.
- Recent outcomes show improved patient survival and reduced acute rejection.
- The multivisceral graft may enhance engraftment and provide a degree of immunologic protection.