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2011 - ISBTS 2011 Symposium

Oral Communications 15: Indications

20.317 - Outcome of intestinal transplants (ITx) for inflammatory bowel disease (IBS)

Presenter: Chirag, Desai, Tucson, United States
Authors: Chirag Desai1, Angelika Gruessner1, Khalid Khan1, Rainer Gruessner1

Outcome of intestinal transplants (ITx) for inflammatory bowel disease (IBS)

Chirag Desai, Angelika Gruessner, Khalid Khan, Rainer Gruessner

Department of Surgery, University of Arizona, College of Medicine, Tucson, AZ, United States

Introduction: Inflammatory bowel diseases, such as Crohn’s disease, form approximately 20% of the overall adult patients undergoing intestinal transplantation (ITx). These patients typically have had many prior abdominal surgeries, fistulae, and abdominal wall complications prior to undergoing transplantation. Their peri-operative course may be challenging and may influence the outcome. In our study, we evaluated their short and long term outcomes.

Methods: United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research (STAR) files were used for this analysis.  All adult ITx recipients from January 2001 were included. We specifically compared the outcome to that of patients who received transplants for mesenteric vascular ischemia (MVI), since these patients are unlikely to have chronic trans-mural intestinal disease.

Results: Sixty three adults received an ITx for Crohn's disease. Of those, 45 (71.4%) were isolated ITx and 18 (28.6%) were liver ITx (L-ITx). Graft survival at 1, 3 and 5 years for isolated ITx was 90%, 65%, and 52% and for L-ITx patients it was 65%, 57%, and 57%. When we evaluated the graft survival for MVI patients at 1, 3, and 5 years for isolated ITx, it was 92%, 64%, and 47% and for L-ITx patients it was 62%, 54%, and 39%. The difference between the same graft type was statistically not significant (P = 0.7). When Crohn's disease was analyzed as an etiological factor in regression analysis for long term outcome of adult patients, it was not a significant factor in any way.

Conclusion: Graft survival is not significantly different for patients undergoing ITx for Crohn’s disease in the current UNOS database analysis.

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