OPTN/SRTR 2021 Annual Data Report: Intestine.

Area of Science:

• Gastroenterology and Hepatology
• Transplantation Surgery
• Clinical Outcomes Research

Background:

• Intestine transplantation has over 30 years of clinical experience.
• Demand for intestine transplants initially rose until 2007, followed by a decline.
• Improvements in pretransplant care for intestinal failure patients contributed to reduced transplant demand.

Purpose of the Study:

• To analyze trends in demand for intestine transplantation over the past decade.
• To evaluate changes in graft survival rates for intestine-alone and combined intestine-liver transplants.
• To assess the impact of pretransplant care advancements on transplant waiting lists.

Main Methods:

• Retrospective analysis of clinical data on intestine transplant demand and outcomes.
• Examination of trends in waiting list additions and performed transplants.
• Calculation of 1- and 5-year graft failure rates for different transplant types.

Main Results:

• Demand for intestine transplants has plateaued or decreased over the last 10-12 years.
• Fewer patients, particularly adults needing combined intestine-liver transplants, are being added to waiting lists.
• No significant improvement in 1- and 5-year graft survival rates has been observed for intestine-alone (21.6%/52.5% failure) or combined intestine-liver allografts (28.6%/47.2% failure).

Conclusions:

• Advancements in pretransplant care have likely reduced the need for intestine transplantation.
• Graft survival rates for intestine transplants remain a significant challenge.
• Future strategies may need to focus on improving long-term graft function and patient outcomes.