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OPTN/SRTR 2015 Annual Data Report: Intestine.

J M Smith1,2, M A Skeans1, S P Horslen3

  • 1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|January 5, 2017
PubMed
Summary
This summary is machine-generated.

Intestine transplants are crucial for intestinal failure, with decreasing pretransplant mortality. However, intestine-liver transplants show higher mortality rates than intestine-only transplants, especially in adults.

Keywords:
Intestinal failureintestine transplantintestine-liver transplantwaiting list

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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.