The United Network for Organ Sharing database was examined for trends in the intestinal transplant (ITx) waitlist from 1993 to 2012, dividing into listings for isolated ITx versus liver-intestine transplant (L-ITx). Registrants added to the waitlist increased from 59/year in 1993 to 317/year in 2006, then declined to 124/year in 2012; Spline modeling showed a significant change in the trend in 2006, p-<-0.001. The largest group of registrants, <1-year of age, determined the trend for the entire population; other pediatric age groups remained stable, adult registrants increased until 2012. The largest proportion of new registrants were for L-ITx, compared to isolated ITx; the change in the trend in 2006 for L-ITx was highly significant, p-<-0.001, but not isolated ITx, p-=-0.270. New registrants for L-ITx, <1-year of age, had the greatest increase and decrease. New registrants for isolated ITx remained constant in all pediatric age groups. Waitlist mortality increased to a peak around 2002, highest for L-ITx, in patients <1-year of age and adults. Deaths among all pediatric age groups awaiting L-ITx have decreased; adult L-ITx deaths have dropped less dramatically. Improved care of infants with intestinal failure has led to reduced referrals for L-ITx. Data from the United Network of Organ Sharing indicate that the number of infants, historically the largest group on the waitlist for liver-intestine transplantation, has reduced dramatically since 2006 while other pediatric groups have remained the same and adults have increased.
- Clinical research/practice
- Organ Procurement and Transplantation Network (OPTN)
- intestine/multivisceral transplantation
- waitlist management