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Title: | Intestinal failure and transplant: The Australian experience (2009 to 2014) | Austin Authors: | Chapman, Brooke ;De Cruz, Peter;Jones, Robert M ;Testro, Adam G | Affiliation: | Nutrition and Dietetics Liver and Intestinal Transplant Unit, Royal Children's Hospital, Melbourne, Victoria, Australia Liver and Intestinal Transplant Unit, Austin Health, Heidelberg, Victoria, Australia Victorian Liver Transplant Unit |
Issue Date: | Mar-2016 | Publication information: | Transplantation Proceedings 2016; 48(2): 463-467 | Abstract: | BACKGROUND: A joint adult and pediatric intestinal transplant (ITx) program for Australia was developed in 2009 to provide life-saving ITx to patients with irreversible intestinal failure (IF). We aimed to analyze the outcomes of patients treated by our service over the past 5 years. METHODS: A retrospective medical record review was conducted on all IF patients referred to our service. Patient demographics, underlying disease, nutrition support, TPN complications, and current transplant program status were evaluated. RESULTS: Fifty-seven patients (35 adults, 40.4 ± 12.4 years; 22 children, 6.3 ± 4.3 years) throughout Australia and New Zealand have been referred. Leading causes of IF were short bowel syndrome followed by pseudo-obstruction. Forty patients (70%) exhibited at least 1 life-threatening complication of PN at referral: liver failure, impending loss of venous access, and/or recurrent line sepsis. Three patients have undergone ITx with 100% survival (median follow-up, 1161 days). Four patients (8%) are listed for transplant, 6 patients (12%) are awaiting transplant assessment, and 4 patients (8%) have died (2 while awaiting transplantation, 2 during assessment period). Causes of death included sepsis and intracranial bleed. Two-thirds of all referred patients (n = 40) were deferred or rejected from wait-listing. CONCLUSIONS: After 5 years of establishing the first dedicated ITx program in Australia and New Zealand, early results indicate that ITx is an available and life-saving option for IF patients in these countries. Current barriers to ITx in Australia include a shortage of appropriate donors and a high rate of donor-specific antibodies among potential recipients. Growing awareness of the service and early referral to assist appropriate patient selection will aid in the program's success. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/13773 | DOI: | 10.1016/j.transproceed.2015.09.071 | ORCID: | Journal: | Transplantation Proceedings | PubMed URL: | https://pubmed.ncbi.nlm.nih.gov/27109979 | Type: | Journal Article | Subjects: | Australia Transplants |
Appears in Collections: | Journal articles |
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