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Postoperative Ileus Murine Model
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OPTN/SRTR 2011 Annual Data Report: intestine
J M Smith1, M A Skeans, B Thompson
1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
Insights
Intestinal transplant rates have decreased, but graft survival has improved. More adult candidates are listed, and recipients now have a higher chance of long-term survival with a functioning intestinal graft.
Area of Science:
- Transplantation Medicine
- Gastroenterology
- Organ Transplantation Statistics
Background:
- The number of intestinal transplant candidates listed annually has declined since 2006, potentially due to advancements in treating intestinal failure.
- Intestinal failure, primarily caused by short-gut syndrome, historically affected a pediatric population, but by 2011, 41% of listed candidates were adults.
- Waiting list times increased and the proportion of high-urgency candidates decreased in 2011.
Purpose of the Study:
- To analyze trends in intestinal transplantation, including candidate demographics, transplant rates, organ utilization, and patient outcomes.
- To assess changes in the intestinal transplant landscape from 2005 to 2011.
- To evaluate graft survival and long-term recipient outcomes post-intestinal transplant.
Main Methods:
- Analysis of national transplant registry data from 2005 to 2011.
- Examination of trends in candidate listing, waiting times, and urgency status.
- Evaluation of transplant rates, organ recovery, and co-transplantation practices.
- Assessment of graft survival and recipient outcomes, including hospitalization rates.
Main Results:
- The overall intestinal transplant rate decreased significantly from 92.7 per 100 wait-list years in 2005 to 49.2 in 2011.
- Fewer intestines were recovered and transplanted per donor, possibly due to a reduced number of listed patients.
- In 2011, 50% of deceased donor intestines were transplanted with another organ, with the pancreas being more common than the historically dominant liver.
- Graft survival has improved, leading to a steady increase in recipients living with a functioning intestinal graft since 1998.
- Hospitalization is frequent, affecting 84.8% of recipients by 6 months and nearly all by 4 years post-transplant.
Conclusions:
- Despite a decline in transplant rates, intestinal transplantation outcomes have improved, with enhanced long-term graft survival.
- The demographic of intestinal transplant candidates has shifted towards a higher proportion of adults.
- Intestinal transplant remains a complex procedure with a high rate of post-transplant hospitalizations, necessitating ongoing research into patient management and care.
Abstract:
Since 2006, the number of new intestinal transplant candidates listed each year has declined, likely reflecting increased medical and surgical treatment for intestinal failure. Historically, intestinal transplant occurred primarily in the pediatric population; in 2011, 41% of prevalent candidates on the waiting list were aged 18 years or older. The most common etiology of intestinal failure remains short-gut syndrome, which encompasses several diagnoses. The proportion of candidates with high medical urgency status decreased and time on the waiting list increased in 2011. The overall rate of transplant decreased from a peak of 92.7 transplants per 100 wait-list years in 2005 to 49.2 in 2011. The number of intestines recovered and transplanted per donor has decreased since 2007, possibly due to fewer listed patients. Almost 50% of deceased donor intestines were transplanted with another organ in 2011. Historically, the most common organ transplanted with the intestine was the liver, but in 2011 it was the pancreas. Graft survival has continued to improve over the past decade, and the number of recipients alive with a functioning intestinal graft has steadily increased since 1998. Hospitalization is common, occurring in 84.8% of recipients by 6 months posttransplant and in almost all by 4 years.
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