INCIDENCE AND PROGRESSION OF RENAL FAILURE IN AN ADULT INTESTINAL TRANSPLANTATION PROGRAM

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incidence of rejection, Graft Vs Host Disease (GVHD) and Post-Transplant Lymphoproliferative Disorders (PTLD).Patients receiving ISBTx for malignant aetiologies were excluded.Statistical analysis was performed using Kaplan-Meier survival curves.Results: Twenty patients underwent ISBTx during the study period, average age at transplant of 47 (23-63 years). 1 year survival of 96%, 5 year survival was 77%.Graft explant occurred in 3 cases (15%) -2 from graft ischaemia, 1 for chronic rejection.One patient was retransplanted, two were re-started on parenteral nutrition.There was 1 case of PTLD, currently undergoing treatment and no cases of GVHD.Acute rejection occurred in 45%; 11% indeterminate histology, 11% grade-1, 33% grade-2 and 45% grade-3 rejection.Chronic rejection in 5%.75% of acute rejection occurred in the first year, 63% was successfully treated with pulsed methylprednisolone monotherapy.Median hospital stay post-transplant was 41 days (21-76), median ITU stay of 3.5 days (2-6).Following ISBTx, 85% of patients required no ongoing parenteral support.Conclusions: ISBTx for benign IF indications delivers excellent outcomes in a cohort of patients that otherwise die.Rejection remains a significant challenge, although this is treatable if detected early and patient frequently achieve total nutritional autonomy with excellent quality of life.

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