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OPTN/SRTR 2017 Annual Data Report: Intestine
J M Smith1,2, T Weaver1, M A Skeans1
1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.
Summary
Intestine transplants are crucial for intestinal failure, with a shift towards adult recipients. Adult candidates face higher mortality, and survival rates vary significantly by age and transplant type.
Area of Science:
- Transplantation Medicine
- Gastroenterology
- Pediatric Surgery
Background:
- Intestine transplantation remains a vital treatment for intestinal failure, despite advances in medical and surgical care.
- The demographic landscape of patients awaiting intestine and intestine-liver transplants has shifted, with a notable increase in adult candidates over the past decade.
Purpose of the Study:
- To analyze the trends in patient demographics on the intestine transplant waitlist.
- To evaluate pretransplant mortality rates across different age groups.
- To assess patient survival outcomes based on age and transplant type.
Main Methods:
- Analysis of intestine and intestine-liver transplant waitlist data from 2017.
- Comparison of age distribution trends in pediatric and adult candidates.
- Calculation of pretransplant mortality rates per 100 waitlist-years.
- Evaluation of 1- and 5-year patient survival rates for different age groups and transplant types.
Main Results:
- In 2017, 109 intestine transplants were performed (62 adults, 47 children).
- Adult candidates (44.0%) showed an increasing proportion on the waitlist, particularly aged 18-34 years.
- Pediatric candidates (56.0%) decreased in the <6 years group but increased in the 6-17 years group.
- Adult candidates had a higher pretransplant mortality rate (7.9/100 waitlist-years) compared to pediatric candidates (3.7/100 waitlist-years).
- Patient survival was lowest for adult intestine-liver recipients (1-year: 66.7%, 5-year: 42.6%) and highest for pediatric intestine recipients (1-year: 86.2%, 5-year: 75.4%).
Conclusions:
- The demographic profile of intestine transplant candidates is evolving towards a larger adult population.
- Age is a significant factor influencing pretransplant mortality and post-transplant survival in intestine recipients.
- Optimized management strategies are needed to address the distinct challenges faced by adult and pediatric patients undergoing intestinal transplantation.
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