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Isolated intestinal transplants vs. liver‐intestinal transplants in adult patients in the United States: 22 yr of OPTN data
Author(s) -
Desai Chirag S.,
Gruessner Angelika C.,
Khan Khalid M.,
Fishbein Thomas M.,
Jie Tun,
Rodriguez Rilo Horacio L.,
Gruessner Rainer W.G.
Publication year - 2011
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2011.01579.x
Subject(s) - medicine , gastroenterology , creatinine , transplantation , bilirubin , surgery
Desai CS, Gruessner AC, Khan KM, Fishbein TM, Jie T, Rodriguez Rilo HL, Gruessner RWG. Isolated intestinal transplants vs. liver‐intestinal transplants in adult patients in the United States: 22 yr of OPTN data. Abstract: We examined the outcomes of adult intestinal transplants (ITx); isolated ITx vs. liver‐intestinal transplants (L‐ITx) were compared using the UNOS database (1987–2009). Of 759 ITx transplants in 687 patients, 463 (61%) were isolated and 296 (39%) were L‐ITx. Patient survival for primary isolated ITx at one, three, and five yr was 84%, 66.7%, and 54.2%; and primary L‐ITx was, 67%, 53.3%, and 46% (p = 0.0005). Primary isolated ITx graft survival at one, three, and five yr was 80.7%, 57.6%, 42.8%; primary L‐ITx was 64.1%, 51%, 44.1% (p = 0.0003 at one, three yr, Wilcoxon test). For retransplants (n = 72), patient and graft survival for isolated ITx (n = 41) at five yr was 40% in era 1 (1987–2000) and 16% in era 2 (p = 0.47); for retransplanted L‐ITx (n = 31), it improved from 14% to 64% in era 2 (p = 0.01). Cox regression: creatinine >1.3 mg/dL and pre‐transplant hospitalization were negative predictors for outcome of both; bilirubin >1.3 mg/dL was a negative predictor for isolated ITx and donor age >40 yr for L‐ITx. Isolated ITx should be considered prior to liver disease for adults with intestinal failure; L‐ITx is preferable for retransplantation.