CHICAGO, May 18 -- With a one-year survival rate of 72 percent, University of Pittsburgh Medical Center (UPMC) surgeons say intestinal transplantation is a viable and a life-saving option for patients with intestinal failure. They reported their results of 127 transplants -- the most performed at any center -- today at the American Society of Transplantation 18th Annual Meeting and Scientific Sessions.
Overall, children between the ages of 2 and 18 had the best success, with a five-year survival rate of 68 percent, reported Kareem Abu-Elmagd, M.D., Ph.D., FACS, associate professor of surgery and director of intestinal transplantation at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute. In addition, 55, or 95 percent, of the 58 patients currently alive are completely off intravenous nutrition, are eating normal diets and have improved quality of life.
Between May 1990 and March 1999, 127 transplants were performed in 121 adults and children who had irreversible intestinal failure.
The small intestine can be transplanted in one of three ways: alone; in combination with the liver; or in combination with the liver, pancreas and stomach. The majority (81 percent) of the patients at the UPMC required intestinal transplants because of short-gut syndrome, the loss of more than 70 percent of the intestine due to trauma, surgery or disease. For adults, short-gut syndrome may be caused by trauma, clotting of the intestine's vessels or Crohn's disease; for children, it may be a volvulus -- a twisting of the intestines, or congenital conditions.
Of the patients reported, 48 received small bowel alone, 58 received liver and small bowel and 15 received multiple organs.
Surgeons reported that a number of factors have contributed to improved one-year
survival, including: improved management of rejection with a three-drug
cocktail of tacrolimus, steroids and daclizumab; refined donor and recipient
selection criteria; and modif
Contact: Lisa Rossi
University of Pittsburgh Medical Center