Official Sections CTRMS ISVCA IPITA IPTA ISODP IRTA IXA SPLIT TID

2013 - ISBTS 2013 Symposium


This page contains exclusive content for the member of the following sections: TTS, IXA, ITA

Mini-Oral Communications 1

12.254 - Long term results after intestinal transplantation from a single South- American center

Presenter: Gabriel, Gondolesi, , Argentina
Authors: Gabriel Eduardo Gondolesi1, Luis Eduardo Moulin1, Constanza Echeverria1, Diego Ramisch1, Fabio Nachman5, Silvia Niveyro2, Guillermo Orce2, Ana Cabanne6, Ana Crivelli1, Maria Ines Martinez1, Julio Trentadue3, Francisco Klein4, Adriana Fernandez1, Pablo Barros Schelotto1, Carolina Rumbo1, Hector Solar Muñiz1

Long term results after intestinal transplantation from a single South- American center

Gabriel Eduardo Gondolesi1, Luis Eduardo Moulin1, Constanza Echeverria1, Diego Ramisch1, Fabio Nachman5, Silvia Niveyro2, Guillermo Orce2, Ana Cabanne6, Ana Crivelli1, Maria Ines Martinez1, Julio Trentadue3, Francisco Klein4, Adriana Fernandez1, Pablo Barros Schelotto1, Carolina Rumbo1, Hector Solar Muñiz1

1Multiorgan Transplant Institute, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 2Department of Anesthesiology, Favaloro's Foundation University Hospital, Ciudad Autónoma de Buenos Aires, Argentina; 3Department of Pediatrics, Favaloro's Foundation Universiti Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 4Intensive Care Unit, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 5Gastroenterology Lab, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 6Department of Pathology, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina

In many countries, intestinal failure patients (pts) had the only option of parenteral nutrition (PN) as available treatment until intestinal transplantation (ITx) evolves as part of a multidisciplinary team. Aim: to report the long term outcomes of a series of ITx performed in children and adults at a single center. Material and Methods: retrospective analysis of all consecutive ITx performed between May 2006 and Dec 2012. Diagnoses, pre ITx mean time on PN, indication for ITx, time and mortality on the waiting list (WL), type of ITx, mean total ischemia time (TIT), and warm ischemia time (WIT), immunosuppressive regimes, time for PN discontinuation, 5 year actuarial patient survival are reported.Results:35 ITx were performed in 21 children and 12 adults; 27 were isolated ITx (3 including colon), 8 multiorgan (MTO) (3 combined, 5 multivisceral - 1 with kidney); 2/35 (5,7%) were re-transplantes: 1 isolated, 1 multivisceral; 11 pts  received the abdominal rectus fascia; 83% presented with short bowel syndrome. The mean time on PN was 53 months (range: 7 to 215- months). The main indication for ITx was lack of central venous accesses followed by PN associated liver disease, and catheter related infectious complications. The mean time on the WL was 159 days (range: 2 to 768 days.Overall mortality in the WL was 7%; 17,2% drop-out of the waiting list. TIT was 8:01±2:06 hs, WIT  was 39±6 min. Mean length of implanted intestine: 329 ± 64 cm Thymoglobulin-Tacrolimus-Sirolimus-Steroids were used in 4 MTO and in 6 isolated ITx recipients transplanted with ABO compatible mismatch grafts or high PRA. The other patients received Anti-IL2 ab-Tacrolimus-Mycophenolate-Steroids. Overall 5 year patient survival is 61%;  and 69% for Isolated ITx. Conclusions: After 6 years of establishing a dedicated program, our results proved that ITx is currently an available option in South America.


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