Age-based disparity in outcomes of intestinal transplants in pediatric patients

Am J Transplant. 2012 Dec:12 Suppl 4:S43-8. doi: 10.1111/j.1600-6143.2012.04107.x. Epub 2012 May 29.

Abstract

Outcomes of intestinal transplants (ITx; n = 977) for pediatric patients are examined using the United Network for Organ Sharing data from 1987 to 2009. Recipients were divided into four age groups: (1) <2 years of age (n = 569), (2) 2-6 years (n = 219), (3) 6-12 years (n = 121) and (4) 12-18 years (n = 68). Of 977 ITx, 287 (29.4%) were isolated ITx and 690 (70.6%) were liver and ITx (L-ITx). Patient survival for isolated ITx at 1, 3 and 5 years, 85.3%, 71.3% and 65.0%, respectively, was significantly better than L-ITx, 68.4%, 57.0% and 51.4%, respectively, (p = 0.0001); this was true for all age groups, except for patients <2 years of age. The difference in graft survival between isolated ITx and L-ITx was significant at 1 and 3 years (Wilcoxon test, p = 0.0012). After attrition analysis of graft survival of patients who survived past first year, 3 and 5 years, graft survival for L-ITx patient was significantly better than those for isolated ITx. Isolated ITx should be considered early before the onset of liver disease in children >2 with intestinal failure but is not advantageous in patients <2 years.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors*
  • Child
  • Child, Preschool
  • Female
  • Graft Rejection / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Intestines / transplantation*
  • Male
  • Organ Transplantation / mortality
  • Organ Transplantation / statistics & numerical data*
  • Retrospective Studies
  • Survival Rate
  • Tissue and Organ Procurement / statistics & numerical data
  • Transplantation*
  • Treatment Outcome
  • Viscera / transplantation