Smith J M, Skeans M A, Horslen S P, Edwards E B, Harper A M, Snyder J J, Israni A K, Kasiske B L
Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.
Department of Pediatrics, University of Washington, Seattle, WA.
Am J Transplant. 2017 Jan;17 Suppl 1:252-285. doi: 10.1111/ajt.14127.
Intestine and intestine-liver transplant remains important in the treatment of intestinal failure, despite decreased morbidity associated with parenteral nutrition. In 2015, 196 new patients were added to the intestine transplant waiting list, with equal numbers waiting for intestine and intestine-liver transplant. Among prevalent patients on the list at the end of 2015, 63.3% were waiting for an intestine transplant and 36.7% were waiting for an intestine-liver transplant. The pretransplant mortality rate decreased dramatically over time for all age groups. Pretransplant mortality was notably higher for intestine-liver than for intestine transplant candidates (respectively, 19.9 vs. 2.8 deaths per 100 waitlist years in 2014-2015). By age, pretransplant mortality was highest for adult candidates, at 19.6 per 100 waitlist years, and lowest for children aged younger than 6 years, at 3.6 per 100 waitlist years. Pretransplant mortality by etiology was highest for candidates with non-congenital types of short-gut syndrome. Numbers of intestine transplants without a liver increased from a low of 51 in 2013 to 70 in 2015. Intestine-liver transplants increased from a low of 44 in 2012 to 71 in 2015. Short-gut syndrome (congenital and non-congenital) was the main cause of disease leading to intestine and to intestine-liver transplant. 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治疗肠衰竭方面仍然很重要。2015年,有196名新患者被列入肠移植等候名单,等待肠移植和肠肝联合移植的人数相等。在2015年底等候名单上的现患患者中,63.3%等待肠移植,36.7%等待肠肝联合移植。随着时间的推移,所有年龄组的移植前死亡率都大幅下降。肠肝联合移植候选者的移植前死亡率明显高于肠移植候选者(2014 - 2015年分别为每100个等候名单年19.9例死亡和2.8例死亡)。按年龄划分,成年候选者的移植前死亡率最高,为每100个等候名单年19.6例,6岁以下儿童最低,为每100个等候名单年3.6例。非先天性短肠综合征候选者的病因移植前死亡率最高。无肝肠移植数量从2013年的最低点51例增加到2015年的70例。肠肝联合移植从2012年的最低点44例增加到2015年的71例。短肠综合征(先天性和非先天性)是导致肠移植和肠肝联合移植的主要疾病原因。成年肠肝联合移植受者的患者生存率最低,儿科肠移植受者的生存率最高。