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Wiley InterScience | ||
  The American Journal of GastroenterologyVolume 101 Issue 7, Pages 1633 - 1643 Published Online: 5 Jul 2006 © 2008 American College of Gastroenterology/Blackwell Publishing Official publication of the American College of Gastroenterology
Abstract | References | Full Text: HTML, PDF (Size: 214K) | Related Articles | Citation Tracking  Candidates for Intestinal Transplantation: A Multicenter Survey in Europe CME To access a continuing medical education exam for this article, please visit http://www.acg.gi.org/journalcme. Copyright 2006 by Am. Coll. of Gastroenterology (Am J Gastroenterol 2006;101:1633–1643) ABSTRACTOBJECTIVES: Epidemiology of candidacy for intestinal transplantation (ITx) and timing for referral for ITx are unknown. Patient candidacy and physician attitudes toward ITx were investigated among centers that participated in previous European surveys on home parenteral nutrition (HPN). METHODS: Patients on HPN for benign intestinal failure (IF) were evaluated by a structured questionnaire. Candidacy was assessed by USA Medicare and American Transplantation Society criteria, categorized as: (1) life-threatening HPN complications; (2) high risk of death because of the gastrointestinal disease; (3) IF with high morbidity or patient HPN refusal. Physicians judged candidacy as immediate or potential. RESULTS: Forty-one centers from nine countries enrolled 688 adults (>18 yr) and 166 pediatric patients; 70% of patients were from five countries which collected 60–100% of their HPN patients. Candidacy was 15.7% in adults and 34.3% in pediatrics (HPN failure, 62.1% and 28.1%; gastrointestinal disease, 25.9% and 59.6%; high morbidity IF or HPN refusal, 12.0% and 12.3%, respectively). Immediate candidacy was required for 14.8% of adult and 15.8% of pediatric candidates (<50% of candidates because of HPN-related liver failure). Among centers, the candidacy rate ranged 0–100% and was negatively associated with the number of patients enrolled in the survey (R=−0.463, p= 0.002). Among the major contributing countries, candidacy ranged 0.3–0.8/million inhabitants for adults and 0.9–2/million inhabitants ≤18 yr for pediatric candidates. CONCLUSIONS: The rate of candidacy and the indications for ITx candidacy differed greatly among age groups and HPN centers; within countries candidacy was more homogeneous; physicians had a generally reserved attitude toward ITx. Received May 31, 2005; accepted October 10, 2005. |  |
