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Related Experiment Videos

Candidacy for intestinal transplantation.

Stephen J D O'Keefe

    The American Journal of Gastroenterology
    |July 26, 2006
    PubMed
    Summary

    Small bowel transplantation survival rates are improving, yet European physicians show reluctance in referring patients with permanent intestinal failure for this procedure. Candidacy rates were notably lower in Europe compared to potential eligibility, even in critical cases.

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    Area of Science:

    • Gastroenterology
    • Transplant Surgery
    • Clinical Medicine

    Background:

    • Recent advancements in small bowel transplantation report over 80% 1-year survival rates, suggesting its potential as an alternative for permanent intestinal failure.
    • A survey of 854 home long-term parenteral nutrition (TPN) patients and physicians across nine European countries investigated candidacy for small bowel transplantation.
    • Pediatric patients demonstrated higher candidacy rates (34%) compared to adults (16%) for small bowel transplantation.

    Discussion:

    • European physicians demonstrated reluctance in referring patients for small bowel transplantation, even when life-threatening complications like liver failure developed.
    • Immediate candidacy for transplantation in adult and pediatric patients with liver failure was significantly lower (36% and 43%, respectively) compared to US acceptance criteria.
    • This reluctance may stem from factors such as inaccessibility to transplant centers or a lack of familiarity with the procedure and its outcomes.

    Key Insights:

    • Despite improved graft and host survival rates in small bowel transplantation, European referral rates remain low.
    • A significant disparity exists in the perceived candidacy for small bowel transplantation between pediatric and adult patients with permanent intestinal failure.
    • Physician-reported candidacy for small bowel transplantation in patients with critical complications like liver failure is notably low in Western Europe.

    Outlook:

    • Further research is needed to understand the barriers to small bowel transplantation referral in Europe.
    • Investigating transplant center accessibility and physician familiarity with small bowel transplantation outcomes is crucial.
    • Addressing these barriers could improve access to life-saving transplantation for patients with permanent intestinal failure.

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