title: Improved outcome after intestinal transplantation at a single institution over 12 years.
abstract: OBJECTIVE
  To evaluate the outcomes of patients undergoing intestinal transplantation (IT).
  
  
  METHODS
  Retrospective review was undertaken using existing medical records and database.
  
  
  RESULTS
  Between November 1991 and May 2003, 114 patients were referred for consideration for IT, of which 33 patients received 37 intestinal allografts. All patients had intestinal failure and all patients had significant complications from total parenteral nutrition (TPN). TPN was the predominant cause of liver failure (63%). Combined liver intestinal grafts were used in the majority of patients. Overall 1- and 3-year patient survival is 77% and 52% with patients transplanted since 1999 having a 1- and 3-year survival of 94% and 73%, respectively. The most common cause of death was sepsis. No graft or patient was lost to cytomegalovirus or Epstein-Barr virus disease. Twenty-seven percent of allografts were lost to rejection. Long-term TPN independence is 82% for grafts more than 30 days after IT. Statistical analysis revealed several important factors impacting outcome.
  
  
  CONCLUSIONS
  Successful IT defined as prolonged patient and graft survival and TPN independence can be readily achieved in select patients with IF and complications related to TPN therapy. Outcomes have improved with experience gained and control of viral infections and rejection.
authors.affiliation: Dumont-UCLA Transplant Program, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. dgfarmer@mednet.ucla.edu
authors.forename: D G
authors.initials: DG
authors.lastname: Farmer
authors.forename: S V
authors.initials: SV
authors.lastname: McDiarmid
authors.forename: S
authors.initials: S
authors.lastname: Edelstein
authors.forename: H
authors.initials: H
authors.lastname: Yersiz
authors.forename: J
authors.initials: J
authors.lastname: Vargas
authors.forename: G
authors.initials: G
authors.lastname: Cortina
authors.forename: J F
authors.initials: JF
authors.lastname: Renz
authors.forename: C
authors.initials: C
authors.lastname: Fondevila
authors.forename: G
authors.initials: G
authors.lastname: Hisatake
authors.forename: L
authors.initials: L
authors.lastname: Reyen
authors.forename: M
authors.initials: M
authors.lastname: Correa
authors.forename: S
authors.initials: S
authors.lastname: Rhodes
authors.forename: A
authors.initials: A
authors.lastname: Zafar
authors.forename: Y
authors.initials: Y
authors.lastname: Chavez
authors.forename: R W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous / Q000379:methods / Q000401:mortality / Q000502:physiology; D016896:Treatment Outcome