33: Living Donor Intestinal Transplantation: a Single-Center Experience

Le résumé fourni par la source

Background: LDITx is not routinely performed because of surgical risks to the donor and the potential inferior physiologic performance of the segmental graft. However, data on the effectiveness of LDITx are scarce. This study aimed to examine outcomes of living-donor intestinal transplant (LDITx) recipients. Methods: This retrospective cohort study included patients undergoing LDITx between May 1999 and December 2022 in intestinal transplant programs in two university-affiliated hospitals in China. Results: Actuarial survival rates were 82%, 75.7%, 68.9% for patient and 76.3%, 66.6%, 63% for graft at 1, 3, and 5 years, respectively. Recipients with > 3/6 HLA-matched grafts had superior patient and graft survival rates than those with ≤ 3/6 HLA-matched grafts (P < 0.05). There were 12 deaths among the recipients, with infection being the leading cause (41.7%), followed by rejection (33.3%), surgical complications (16.7%), and others (8.3%). There were 16 graft losses among the recipients, with acute cellular rejection being the predominant cause (37.5%), followed by infection (25%), technical failure (12.5%), chronic rejection (12.5%), and others (12.5%). With an average follow-up of 3.8 (range, 0.7-24) years, the rates of acute and chronic rejection were 33% and 4%, and the rate of CMV disease and PTLD were 5% and 2.5%, respectively. Of the 46 patients, 34 (73.9%) are currently alive and have achieved enteral autonomy. None of the donors experienced life-threatening complications or mortality. Six (15%) of 46 donors experienced minor operative complications. Conclusions: LDITx is a valuable treatment option for patients with end-stage intestinal failure. Living-donor ileal resection is associated with minimal short- and long-term morbidity and remains an attractive alternative for potential recipients when suitable deceased donors are unavailable.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.