Initiation of an intestinal transplant program: The indiana experience

Rodrigo M. Vianna, Richard S. Mangus, Jonathan A. Fridell, Marwan Kazimi, Edward Hollinger, Joseph Tector

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

INTRODUCTION.: Establishment of a new intestinal transplant (Itx) program in the United States entails significant programmatic costs and a steep learning curve. We report results of the first 4 years of the program at Indiana University. METHODS.: Forty-six intestinal and multivisceral transplants (MVtx) were performed between 2003 and 2007. All organ procurements were performed by our team. Immunosuppression included an induction protocol combined with maintenance tacrolimus monotherapy. Scheduled rejection surveillance was with magnification endoscopy. RESULTS.: Forty-three patients (13 children and 30 adults) received 10 Itx (22%), 5 modified MVtxs (11%), and 31 (MVtx, 67%). Recipient ages ranged from 3 months to 66 years, with median follow-up time of 15 months. Thirty-five patients are currently alive (81%). Patient and graft survival at 30 days was 85%/86% in pediatric and 93%/91% in adult; overall survival was 69%/64% in pediatric and 87%/75% in adult. Thirty patients (69%) experienced episodes of rejection. Multivisceral transplanted patients experienced less episodes of severe rejection (2/31, 6%) when compared with patients with isolated Itx and modified MVtxs. Retransplantation was performed in three patients with nonresponsive severe acute rejection. CONCLUSION.: The Indiana University Intestinal and Multivisceral Transplant program experienced significant early graft loss and mortality among pediatric patients, but not among adults. This discrepancy resolved within 2 years of program initiation. After 4 years, adult and pediatric graft and patient survival statistics are similar to those at other programs.

Original languageEnglish (US)
Pages (from-to)1784-1789
Number of pages6
JournalTransplantation
Volume85
Issue number12
DOIs
StatePublished - Jun 27 2008

Keywords

  • Intestinal transplantation
  • Multivisceral transplantation
  • Transplant outcomes

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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    Vianna, R. M., Mangus, R. S., Fridell, J. A., Kazimi, M., Hollinger, E., & Tector, J. (2008). Initiation of an intestinal transplant program: The indiana experience. Transplantation, 85(12), 1784-1789. https://doi.org/10.1097/TP.0b013e31817889a1