OPTN/SRTR 2015 Annual Data Report: Intestine

Area of Science:

• Transplantation Medicine
• Gastroenterology
• Surgical Oncology

Background:

• Intestine and intestine-liver transplantation are vital for managing intestinal failure, even with advances in parenteral nutrition.
• Despite improvements, significant numbers of patients remain on transplant waiting lists.

Purpose of the Study:

• To analyze trends in intestine and intestine-liver transplantation, including waiting list dynamics, pretransplant mortality, and patient survival.
• To identify factors influencing pretransplant mortality and outcomes in different recipient age groups and transplant types.

Main Methods:

• Retrospective analysis of national transplant waiting list data.
• Examination of pretransplant mortality rates stratified by transplant type, age, and etiology.
• Comparison of patient survival rates for different transplant categories.

Main Results:

• In 2015, 196 new patients were added to the waiting list, with a near-equal split between intestine and intestine-liver candidates.
• Pretransplant mortality rates have decreased significantly over time but remain higher for intestine-liver (19.9 deaths/100 waitlist years) compared to intestine-only transplants (2.8 deaths/100 waitlist years).
• Adult candidates face the highest pretransplant mortality (19.6 deaths/100 waitlist years), and short-gut syndrome is the primary indication for both transplant types.

Conclusions:

• Intestine transplantation, both with and without liver, is increasing, with short-gut syndrome as the main indication.
• While overall pretransplant mortality is declining, intestine-liver transplantation carries a substantially higher risk, particularly for adult recipients.
• Optimizing outcomes requires continued focus on reducing pretransplant mortality and improving survival rates, especially for complex cases.