Transplantation effective for intestine failure
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Intestine transplantation has become the definitive treatment for patients with end-stage disease of the intestines who cannot tolerate intravenous nutrition, according to data from the Intestinal Transplant Registry.
All 61 programs that perform intestine transplants and are enrolled in the registry responded to a survey conducted by Dr. David Grant, at Toronto General Hospital in Canada, and his associates.
The responses provided data on 989 transplants performed between 1985 and 2003.
According to the team’s report in the Annals of Surgery, 61 percent of intestinal transplant recipients were 18 years old or younger. One-year survival now exceeds 80 percent, and more than 90 percent of recipients have been able to stop intravenous nutrition and resume normal daily activities.
The longest survivor has been on an oral diet for more than 14 years.
Further analysis identified two factors associated with increased transplant survival: being well enough to wait at home versus being hospitalized while awaiting transplantation, and the use of certain immunosuppressive drugs.
In addition to these factors, center experience with 10 or more total cases and recipients’ age are also significantly associated with patient survival.
Intestine transplantation quickly pays for itself, Grant’s team adds. It “is highly cost-effective after 2 years in comparison to the costs of long-term (intravenous) nutrition,” they note.
SOURCE: Annals of Surgery, April 2005.
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