Intestinal transplantation is a possibility for those who have persistent intestinal failure due to parenteral feeding intolerance. The goal of this study was to assess long-term intestinal transplant survival in pediatric patients at our clinic and to discover variables that influence survival. Retrospective chart study of 86 patients transplanted between 2003 and 2013, looking for potential explanatory variables including as demographics, perioperative events, and postoperative problems. After 5 and 10 years, intestinal transplant survival was 71% and 65%, respectively. Five-year graft survival was achieved in 79 percent of patients with a history of anatomic intestinal failure vs 45 percent of patients with functional intestinal failure. 5-year graft survival was also linked with decreased rates of graft-versus-host disease, post-transplant lymphoproliferative disorder, and de novo donor-specific antibodies, as well as a lower donor-recipient weight ratio. Transplant rejection of any degree and the presence of a liver graft were not related with 5-year intestinal graft survival. Factors related with transplant survival after 10 years were comparable to those associated with graft survival after 5 years.
Morphological but not functional intestinal failure results have significantly improved in juvenile intestine transplantation. Graft survival is dependent on avoiding severe viral and immunological problems, such as GVHD, whereas adding a liver graft has no clear survival advantage. Reduced success with functional intestinal failure might be attributed to this group’s natural sensitivity to problems.
