Smith J M, Skeans M A, Horslen S P, Edwards E B, Harper A M, Snyder J J, Israni A K, Kasiske B L
Department of Pediatrics, University of Washington, Seattle, WA.
Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.
Am J Transplant. 2016 Jan;16 Suppl 2:99-114. doi: 10.1111/ajt.13669.
Intestine and intestine-liver transplant plays an important role in the treatment of intestinal failure, despite decreased morbidity associated with parenteral nutrition. In 2014, 210 new patients were added to the intestine transplant waiting list. Among prevalent patients on the list at the end of 2014, 65% were waiting for an intestine transplant and 35% were waiting for an intestine-liver transplant. The pretransplant mortality rate decreased dramatically over time for all age groups. Pretransplant mortality was highest for adult candidates, at 22.1 per 100 waitlist years compared with less than 3 per 100 waitlist years for pediatric candidates, and notably higher for candidates for intestine-liver transplant than for candidates for intestine transplant without a liver. Numbers of intestine transplants without a liver increased from a low of 51 in 2013 to 67 in 2014. Intestine-liver transplants increased from a low of 44 in 2012 to 72 in 2014. Short-gut syndrome (congenital and other) was the main cause of disease leading to both intestine and intestine-liver transplant. Graft survival improved over the past decade. Patient survival was lowest for adult intestine-liver recipients and highest for pediatric intestine recipients.
尽管肠外营养相关的发病率有所下降,但肠移植和肠肝联合移植在肠衰竭的治疗中仍发挥着重要作用。2014年,有210名新患者加入了肠移植等待名单。在2014年末名单上的现存患者中,65%等待肠移植,35%等待肠肝联合移植。随着时间推移,所有年龄组的移植前死亡率均显著下降。成年候选者的移植前死亡率最高,每100个等待名单年为22.1,而儿科候选者每100个等待名单年低于3,且肠肝联合移植候选者的死亡率明显高于单纯肠移植候选者。单纯肠移植的数量从2013年的最低点51例增加到2014年的67例。肠肝联合移植从2012年的最低点44例增加到2014年的72例。短肠综合征(先天性及其他)是导致肠移植和肠肝联合移植的主要疾病原因。在过去十年中,移植物存活率有所提高。成年肠肝联合移植受者的患者存活率最低,儿科肠移植受者的患者存活率最高。