Internal medicine journal · 2026
Intestinal transplantation in Australia: progress, challenges and future directions.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Chapman Brooke, Wong Darren, Starkey Graham, Perini Marcos, Yap Jason, Testro Adam
Аннотация
BACKGROUND: Intestinal transplant is a rare procedure reserved for patients with intestinal failure who cannot be sustained on total parenteral nutrition due to severe, life-threatening complications. This study aims to describe the activity and outcomes of intestinal transplantation undertaken in Australia.
METHODS: Observational retrospective cohort study of all adult and paediatric patients who have received an intestinal transplant in Australia. The primary outcomes were patient and graft survival, with secondary outcomes including incidence of post-transplant enteral autonomy and post-transplant complications.
RESULTS: Nineteen patients (14 adults, five children) received a total of 20 intestinal transplants in Australia between 2010 and 2026. One-year conditional graft and patient survival was 87% and 93% respectively, with 5-year conditional graft and patient survival rates of 67% and 75% respectively. The median time to cease total parenteral nutrition and achieve enteral autonomy after transplant was 21 days (interquartile range: 17-30 days). Median body mass index was within ideal range for adult patients by 12 months post-transplant and growth centiles improved for paediatric patients. Eight patients (40%) experienced a total of 14 episodes of rejection at a median onset of 7.5 months after transplant, of which five were graded severe. Rates of post-transplant lymphoproliferative disorder and graft-versus-host disease were low (5% each).
CONCLUSIONS: The Australian Intestinal Transplant Service demonstrates excellent patient outcomes, with short- to medium-term graft and patient survival similar to that of leading international centres and enteral autonomy achieved in all patients. Intestinal transplant is now an acceptable, life-saving procedure in appropriately selected patients in our region.
METHODS: Observational retrospective cohort study of all adult and paediatric patients who have received an intestinal transplant in Australia. The primary outcomes were patient and graft survival, with secondary outcomes including incidence of post-transplant enteral autonomy and post-transplant complications.
RESULTS: Nineteen patients (14 adults, five children) received a total of 20 intestinal transplants in Australia between 2010 and 2026. One-year conditional graft and patient survival was 87% and 93% respectively, with 5-year conditional graft and patient survival rates of 67% and 75% respectively. The median time to cease total parenteral nutrition and achieve enteral autonomy after transplant was 21 days (interquartile range: 17-30 days). Median body mass index was within ideal range for adult patients by 12 months post-transplant and growth centiles improved for paediatric patients. Eight patients (40%) experienced a total of 14 episodes of rejection at a median onset of 7.5 months after transplant, of which five were graded severe. Rates of post-transplant lymphoproliferative disorder and graft-versus-host disease were low (5% each).
CONCLUSIONS: The Australian Intestinal Transplant Service demonstrates excellent patient outcomes, with short- to medium-term graft and patient survival similar to that of leading international centres and enteral autonomy achieved in all patients. Intestinal transplant is now an acceptable, life-saving procedure in appropriately selected patients in our region.