TY - JOUR
T1 - Intestinal retransplantation
T2 - Analysis of organ procurement and transplantation network database
AU - Desai, Chirag S.
AU - Khan, Khalid M.
AU - Gruessner, Angelika C.
AU - Fishbein, Thomas M.
AU - Gruessner, Rainer W.G.
PY - 2012/1/15
Y1 - 2012/1/15
N2 - 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.
AB - 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.
KW - Intestine
KW - Retransplant
KW - Transplant
UR - http://www.scopus.com/inward/record.url?scp=84655161435&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84655161435&partnerID=8YFLogxK
U2 - 10.1097/TP.0b013e31823aa54d
DO - 10.1097/TP.0b013e31823aa54d
M3 - Article
C2 - 22113492
AN - SCOPUS:84655161435
VL - 93
SP - 120
EP - 125
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 1
ER -