title: Waitlist characteristics of patients at a single-center intestinal and multivisceral transplant program.
abstract: Intestinal transplantation (ITX) can be a successful treatment for patients with irreversible intestinal failure and associated severe complications. Because of long waiting periods and organ shortages, the precise identification of eligible patients and their early referral to centers that perform ITX is important. We retrospectively analyzed all patients who were referred to our center between 2000 and 2011 concerning their referral criteria, waitlist characteristics, and outcome. A total of 87 patients (47 male patients, 40 female patients; median age 39.8 ± 13.4 years) were referred to our center. All patients presented with intestinal failure caused by short bowel syndrome or motility disorders. About 80.5% of patients were evaluated for isolated ITX, modified multivisceral (mMVTX), or multivisceral transplantation (MVTX). About 56.3% were listed at EUROTRANSPLANT, 33.3% suffered from severe secondary organ failure requiring MVTX, and 34.5% were transplanted. 14.3% (all MVTX-candidates) died on the waitlist as a result of infectious complications. The high proportion of MVTX candidates underlines the need for early referral to specialized centers. MVTX-candidates have a high waitlist mortality for different reasons. However, the current allocation policy for MVTX does not mirror the severity of disease and may therefore contribute to high waitlist mortality.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Undine A
authors.initials: UA
authors.lastname: Gerlach
authors.forename: Anja
authors.initials: A
authors.lastname: Reutzel-Selke
authors.forename: Ulrich-Frank
authors.initials: UF
authors.lastname: Pape
authors.forename: Dinah
authors.initials: D
authors.lastname: Joerres
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Andreas
authors.initials: A
authors.lastname: Pascher
mesh_terms: D000328:Adult; D002779:Cholestasis / Q000209:etiology; D058625:End Stage Liver Disease / Q000209:etiology; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012189:Retrospective Studies; D014850:Waiting Lists
chemical_list: D006680:HLA Antigens