Age-based disparity in outcomes of intestinal transplants in pediatric patients.
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.
Department of Surgery, University of Arizona, Tucson, AZ, USA. csdesai@gmail.com
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CS
Desai
F B
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Maegawa
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Gruessner
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Gruessner
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Gruesner
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Khan
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D008297:Male; D016377:Organ Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D014180:Transplantation; D016896:Treatment Outcome; D014781:Viscera / Q000637:transplantation