Intestine transplantation in the United States, 1999-2008: Special feature

G. V. Mazariegos, D. E. Steffick, S. Horslen, D. Farmer, J. Fryer, D. Grant, Alan Norman Langnas, J. C. Magee

Research output: Contribution to journalReview article

91 Scopus citations

Abstract

Improving short-term results with intestine transplantation have allowed more patients to benefit with nearly 700 patients alive in the United States with a functioning allograft at the end of 2007. This success has led to an increase in demand. Time to transplant and waiting list mortality have significantly improved over the decade, but mortality remains high, especially for infants and adults with concomitant liver failure. The approximately 200 intestines recovered annually from deceased donors represent less than 3% of donors who have at least one organ recovered. Consent practice varies widely by OPTN region. Opportunities for improving intestine recovery and utilization include improving consent rates and standardizing donor selection criteria. One-year patient and intestine graft survival is 89% and 79% for intestine-only recipients and 72% and 69% for liver-intestine recipients, respectively. By 10 years, patient and intestine survival falls to 46% and 29% for intestine-only recipients, and 42% and 39% for liver-intestine, respectively. Immunosuppression practice employs peri-operative antibody induction therapy in 60% of cases; acute rejection is reported in 30%-40% of recipients at one year. Data on long-term nutritional outcomes and morbidities are limited, while the cause and therapy for late graft loss from chronic rejection are areas of ongoing investigation.

Original languageEnglish (US)
Pages (from-to)1020-1034
Number of pages15
JournalAmerican Journal of Transplantation
Volume10
Issue number4 PART 2
DOIs
StatePublished - Apr 1 2010

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Keywords

  • Intestine transplantation and donation
  • Outcomes
  • Waiting list mortality

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Mazariegos, G. V., Steffick, D. E., Horslen, S., Farmer, D., Fryer, J., Grant, D., Langnas, A. N., & Magee, J. C. (2010). Intestine transplantation in the United States, 1999-2008: Special feature. American Journal of Transplantation, 10(4 PART 2), 1020-1034. https://doi.org/10.1111/j.1600-6143.2010.03044.x