Intestinal transplant registry report: global activity and trends

Area of Science:

• Gastroenterology and Hepatology
• Transplantation Surgery
• Immunology

Background:

• The International Intestine Transplant Registry has collected data since 1985.
• Individual center reports on intestine transplantation (IT) have limited generalizability due to small case volumes.
• Recent global IT activity requires examination to understand current trends and outcomes.

Purpose of the Study:

• To assess recent global trends in intestine transplantation (IT) activity.
• To analyze factors influencing graft survival in IT.
• To identify challenges and opportunities in improving IT outcomes.

Main Methods:

• Descriptive statistics were used to analyze IT activity.
• Kaplan-Meier survival curves were employed to assess patient and graft survival.
• Multivariable analysis identified factors associated with improved graft survival.

Main Results:

• Eighty-two programs reported 2887 IT procedures in 2699 patients.
• Actuarial patient survival rates are 76% (1 year), 56% (5 years), and 43% (10 years).
• Grafts including a colon segment showed better function; waiting at home, induction immunosuppression, liver component inclusion, and rapamycin maintenance were linked to better graft survival.

Conclusions:

• Intestine transplantation outcomes have modestly improved over the last decade, with similar regional practices globally.
• Despite improvements, late graft loss rates have not changed, and case volumes have declined.
• Low center case volumes hinder the identification of root causes for late graft loss, highlighting the Registry's importance for future research.