BACKGROUND: We evaluated the outcomes of intestinal retransplantation in children and adults in the United States. METHODS: The United Network for Organ Sharing data were analyzed from October 1987 to August 2009. RESULTS: In adult isolated intestinal transplant (ITx) retransplants (n=41), patient survival was 80.1%, 47.4%, and 28.5% at 1, 3, and 5 years, which was worse than primary isolated ITx (P=0.005). For liver ITx (L-ITx) retransplants (n=31), patient survival was 63.1%, 56.1%, and 46.8% and was not significantly different than primary L-ITx. In pediatric isolated ITx retransplants (n=28), patient survival at 1, 3, and 5 years was 80.7%, 74%, and 57.5%; graft survival was 76.4%, 56.6%, and 44%. In L-ITx retransplants (n=49), patient survival was 42%, 42%, and 42%; graft survival was 39%, 39%, and 39%. Patient and graft survival in adult L-ITx retransplants were better in era 2 (January 2001-August 2009) than era 1 (October 1987-December 2000) (P=0.01). Among pediatric L-ITx retransplants, outcomes were worst in children younger than 2 years (n=12). In regression analysis, prior hospitalization was a negative predictor for all the groups of patients (relative risk, 5.4). CONCLUSION: Patient and graft survival in adult isolated ITx are less favorable after a retransplant compared with a primary transplant. Patient and graft survival are also poor in pediatric L-ITx after a retransplant, especially for children younger than 2 years of age. L-ITx retransplant results improved significantly in era 2 in adult recipients.
BACKGROUND: We evaluated the outcomes of intestinal retransplantation in children and adults in the United States. METHODS: The United Network for Organ Sharing data were analyzed from October 1987 to August 2009. RESULTS: In adult isolated intestinal transplant (ITx) retransplants (n=41), patient survival was 80.1%, 47.4%, and 28.5% at 1, 3, and 5 years, which was worse than primary isolated ITx (P=0.005). For liver ITx (L-ITx) retransplants (n=31), patient survival was 63.1%, 56.1%, and 46.8% and was not significantly different than primary L-ITx. In pediatric isolated ITx retransplants (n=28), patient survival at 1, 3, and 5 years was 80.7%, 74%, and 57.5%; graft survival was 76.4%, 56.6%, and 44%. In L-ITx retransplants (n=49), patient survival was 42%, 42%, and 42%; graft survival was 39%, 39%, and 39%. Patient and graft survival in adult L-ITx retransplants were better in era 2 (January 2001-August 2009) than era 1 (October 1987-December 2000) (P=0.01). Among pediatric L-ITx retransplants, outcomes were worst in children younger than 2 years (n=12). In regression analysis, prior hospitalization was a negative predictor for all the groups of patients (relative risk, 5.4). CONCLUSION:Patient and graft survival in adult isolated ITx are less favorable after a retransplant compared with a primary transplant. Patient and graft survival are also poor in pediatric L-ITx after a retransplant, especially for children younger than 2 years of age. L-ITx retransplant results improved significantly in era 2 in adult recipients.
Authors: Ahmed M Elsabbagh; Jason Hawksworth; Khalid M Khan; Stuart S Kaufman; Nada A Yazigi; Alexander Kroemer; Coleman Smith; Thomas M Fishbein; Cal S Matsumoto Journal: Am J Transplant Date: 2019-03-26 Impact factor: 8.086
Authors: Elizabeth Harrison; Philip Allan; Amrutha Ramu; Anil Vaidya; Simon Travis; Simon Lal Journal: World J Gastroenterol Date: 2014-03-28 Impact factor: 5.742