Developing trends in the intestinal transplant waitlist

K. M. Khan*, C. S. Desai, M. Mete, S. Desale, R. Girlanda, J. Hawksworth, C. Matsumoto, S. Kaufman, T. Fishbein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)2830-2837
Number of pages8
JournalAmerican Journal of Transplantation
Volume14
Issue number12
DOIs
StatePublished - 1 Dec 2014
Externally publishedYes

Keywords

  • Clinical research/practice
  • Organ Procurement and Transplantation Network (OPTN)
  • intestine/multivisceral transplantation
  • waitlist management

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