4.1 Review

Long-term outcomes of intestinal transplantation

Journal

CURRENT OPINION IN ORGAN TRANSPLANTATION
Volume 26, Issue 2, Pages 192-199

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOT.0000000000000855

Keywords

chronic rejection; health-related quality of life; intestinal transplantation; long-term outcomes; nutrition

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The article discusses the mortality, morbidity, complications, nutritional, and psychosocial outcomes in intestinal transplant recipients, with a focus on long-term survivors. Recent data shows improvements in survival rates, with most patients doing well in the long-term. However, there are ongoing challenges in areas like infectious complications, renal function, and mental health.
Purpose of review In this article, data from the intestinal transplant registry, recent publications and reviews in the field will be used to describe mortality, morbidity, complications, nutritional and psychosocial outcomes in intestinal transplant recipients with a focus on those furthest out from transplant. Recent findings Registry data show static long-term survival data (41% 10-year survival in the most recent analysis), but experienced centres report improvements with survival between 60 and 70% at 10 years. Chronic rejection remains a problem for long-term graft survival, but understanding of humoral immunity is increasing. Nutritional outcomes are good with most recipients achieving enteral autonomy with an unrestricted diet. Health-related quality of life data generally shows improvement in the years after transplant, educational attainment is good, but some patients have ongoing psychosocial problems. Most patients do well in the long-term after transplant. Survival outcomes have improved in experienced centres, and nutrition and quality of life outcomes are good. Recognition of psychosocial outcomes is increasing. Nevertheless, challenges remain in areas such as infectious complications, renal function, chronic rejection, social support and mental health.

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