Charlotte Pither¹, Samantha Duncan¹, Helen Tincknell¹, Myla Manligod¹, Simon Gabe², Beate Mengelkoch¹, Jeremy Woodward¹, Bridget Chukualim¹, Andrew Butler¹, Stephen Middleton¹

¹Gastroenterology and Transplantation Departments, Addenbrookes, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom; ²St Mark's intestinal failure and academic unit, St Mark's Hospital. Harrow, London, United Arab Emirates

Introduction: Survival following intestinal transplantation has substantially improved over the last decade and in the last 5 years our centre reports a 3 year survival of 94%. As survival improves and approaches that achieved on parenteral nutrition the possibility of transplantation as an attempt to improve quality of life(QOL) will be considered more frequently. It is therefore important to establish if QOL can be enhanced by transplantation and whether there are particular aspects of QOL that are more inclined to improve than others which may be more refractory or even deteriorate.

Methods: We evaluated QOL in our patient cohort of 18 consecutive patients who have either undergone (n=11) or been selected for transplantation (n=7). QOL was assessed using the short form 36 scheme (SF36) which semi-quantifies 8 QOL categories (Physical function, Role physical, Role emotional, Energy, emotional wellbeing, social functioning, pain, and general health) and combines these to give an overall QOL score for each patient.

Results: Post-operative SF36 scores for physical functioning (p=0.021), social functioning (p=0.0024) and general health (p=0.034) were significantly better than pre-operatively. Paired pre and post operative data was available for 6 patients, QOL significantly improved in 2, remained unchanged in 2 and deteriorated in 1.

Conclusion: Intestinal transplantation is now associated with excellent medium term survival. In this small cohort 50% of patients experienced a significant improvement in QOL. There was an overall trend for better quality of life after transplantation than in the preoperative period and in particular general health, physical and social functioning improved. From this experience it appears that a proportion of patients experience an improvement in QOL following intestinal transplantation. More work in this area is needed to identify which patients have the greatest chance of improvement, and might therefore be offered earlier transplantation on this basis.