Isolated intestinal transplants vs. liver-intestinal transplants in adult patients in the united states

22yr of optn data

Chirag S. Desai, Angelika C Gruessner, Khalid M. Khan, Thomas M. Fishbein, Tun Jie, Horacio L. Rodriguez Rilo, Rainer W G Gruessner

Research output: Contribution to journalArticle

12 Citations (Scopus)

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 fiveyr 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 fiveyr was 80.7%, 57.6%, 42.8%; primary L-ITx was 64.1%, 51%, 44.1% (p=0.0003 at one, threeyr, Wilcoxon test). For retransplants (n=72), patient and graft survival for isolated ITx (n=41) at fiveyr 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 >1.3mg/dL and pre-transplant hospitalization were negative predictors for outcome of both; bilirubin >1.3mg/dL was a negative predictor for isolated ITx and donor age >40yr for L-ITx. Isolated ITx should be considered prior to liver disease for adults with intestinal failure; L-ITx is preferable for retransplantation.

Original languageEnglish (US)
Pages (from-to)622-628
Number of pages7
JournalClinical Transplantation
Volume26
Issue number4
DOIs
StatePublished - Jul 2012

Fingerprint

Transplants
Liver
Graft Survival
Bilirubin
Liver Diseases
Creatinine
Hospitalization
Tissue Donors
Databases
Survival

Keywords

  • Intestine
  • Liver-intestinal
  • Transplant

ASJC Scopus subject areas

  • Transplantation

Cite this

Isolated intestinal transplants vs. liver-intestinal transplants in adult patients in the united states : 22yr of optn data. / Desai, Chirag S.; Gruessner, Angelika C; Khan, Khalid M.; Fishbein, Thomas M.; Jie, Tun; Rodriguez Rilo, Horacio L.; Gruessner, Rainer W G.

In: Clinical Transplantation, Vol. 26, No. 4, 07.2012, p. 622-628.

Research output: Contribution to journalArticle

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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 fiveyr 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 fiveyr was 80.7{\%}, 57.6{\%}, 42.8{\%}; primary L-ITx was 64.1{\%}, 51{\%}, 44.1{\%} (p=0.0003 at one, threeyr, Wilcoxon test). For retransplants (n=72), patient and graft survival for isolated ITx (n=41) at fiveyr 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 >1.3mg/dL and pre-transplant hospitalization were negative predictors for outcome of both; bilirubin >1.3mg/dL was a negative predictor for isolated ITx and donor age >40yr for L-ITx. Isolated ITx should be considered prior to liver disease for adults with intestinal failure; L-ITx is preferable for retransplantation.",
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AU - Khan, Khalid M.

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