OPTN/SRTR 2024 Annual Data Report: Intestine.

Area of Science:

• Transplantation surgery
• Gastroenterology
• Immunology

Background:

• Intestine transplantation is a complex procedure for diverse conditions impacting quality of life.
• Transplants can be performed with or without a liver transplant, sometimes including other organs like the stomach, pancreas, or colon.
• In 2024, 128 individuals were added to the US intestine transplant waiting list, with short-gut syndrome being common, but motility disorders, mesenteric thromboses, and tumors increasingly prevalent.

Purpose of the Study:

• To analyze the 2024 trends in intestine transplant waiting lists and outcomes.
• To compare graft survival rates for intestine-only versus intestine-with-liver transplants.
• To report on acute rejection rates in recent intestine transplant recipients.

Main Methods:

• Analysis of waiting list data from 2024, including demographics and diagnoses.
• Review of graft survival statistics for adult and pediatric recipients from 2017-2019.
• Examination of acute rejection rates within the first year post-transplant for recent cohorts.

Main Results:

• In 2024, 97 intestine transplants were performed, with 32 in pediatric recipients.
• No deaths were reported on the waiting list for intestine-without-liver transplants, contrasting with 11 deaths for intestine-with-liver transplants.
• 1- and 5-year graft survival rates differed significantly between intestine-only and intestine-with-liver transplants, and between adult and pediatric recipients.
• 44% of the most recent cohort experienced acute rejection within the first year.

Conclusions:

• Intestine transplant remains a vital option for patients with severe gastrointestinal conditions.
• Outcomes and waiting list mortality vary significantly depending on whether a liver transplant is included.
• The expanding indications and evolving demographics for intestine transplantation necessitate ongoing monitoring and research.