Survival of Patients Identified as Candidates for Intestinal Transplantation: A 3-Year Prospective Follow-Up

Pironi, Loris; Forbes, Alastair; Joly, Francisca; Colomb, V.; Łyszkowska, M.; Gossum, A. Van; Baxter, J.; Thul, P.; Hébuterne, Xavier; Gambarara, M.; Gottrand, Frédéric; Villares, José Manuel Moreno; Messing, Bernard; Goulet, Olivier; Staun, Michael

doi:10.1053/j.gastro.2008.03.043

Cited by 102 publications

(61 citation statements)

References 27 publications

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“…Since major advances have occurred in the treatment of IF over the past decade, it is not surprising that many of the indications that were important in an earlier era are less relevant today and were found to have poor sensitivity and PPV in the modern era of IF (Table 3). Pironi et al reported that children and adults who met the 2001 listing criteria had an 87% survival after 3 years on long-term PN, which is similar to the 94% in patients who did not meet listing criteria and continued PN therapy (15). However, a significantly lower survival was documented in patients with PN failure (progressive liver failure, loss of vascular access, recurrent sepsis).…”

Section: Discussionmentioning

confidence: 94%

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Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Burghardt

Wales

Silva³

et al. 2015

American Journal of Transplantation

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Current listing indications used for intestinal transplantation (IT) were proposed in 2001. We undertook the present single center study to see if these criteria are still valid. The 2001 criteria (advanced cholestasis, loss of >50% central venous catheter (CVC) sites, !2 sepsis/year, ultrashort bowel) were compared in children with intestinal failure in old era-1998-2005 (N ¼ 99) to current era-2006-2012 (N ¼ 91) to predict the need for IT using sensitivity, specificity, NPV and PPV. Two 2001 criteria had poorer predictive value in the current era: Advanced cholestasis (PPV 64% old vs. 40% current era; sensitivity 84% vs. 65%, respectively) and ultrashort bowel (PPV 100% old vs. 9% current era; sensitivity 10% vs. 4%, respectively). Three newly proposed criteria had high predictive value: !2 ICU admissions (p ¼ 0.0001, OR 23.6, 95% CI 2.7-209.8), persistent bilirubin >75 mmol/L despite lipid strategies (p ¼ 0.0005, OR 24.0, 95% CI 3.2-177.4), and loss of !3 CVC sites (p ¼ 0.0003, OR 33.3,).There was 98% probability of needing IT when two of these new criteria were present. The 2001 IT criteria have limited predictive ability in the current era and should be revised. A multicenter study is required to validate the findings of this single center experience.

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Section: Discussionmentioning

confidence: 94%

“…Ultrashort bowel was defined as 20 cm. Advanced cholestasis: Defined as a 2-week period where the conjugated bilirubin level was sustained at !100 micromol/L and not part of an episode of sepsis, urinary tract infection (UTI) or peri-operative period (2,14,15).…”

Section: Study Definitionsmentioning

confidence: 99%

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Burghardt

Wales

Silva³

et al. 2015

American Journal of Transplantation

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“…55 Intestinal transplantation has also been proposed as a rescue therapy, but indication during CIF remains controversial. 15,56 In future, improvement of the results of transplantation may lead to a reassessment of the risk ⁄ benefit balance, with a possible alternative treatment to HPN.…”

Section: Discussionmentioning

confidence: 99%

Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Elriz

Palascak-Juif

Joly

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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“…The results of ITx have improved over the last decade (2). When long-term survival rate after ITx, as well as the rate of treatment-associated death, become similar to those on HPN, ITx could be proposed as a rehabilitative procedure to all the patients with irreversible IF (3,4).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

Pironi

Baxter²,

Lauro

et al. 2012

American Journal of Transplantation

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In order to investigate the quality of life on home parenteral nutrition and after intestinal transplantation using comparable questionnaires, the treatmentspecific quality of life questionnaire for adult patients on home parenteral nutrition was adapted for intestinal transplant recipients. Both instruments were composed of 8 functional scales, 9 symptom scales, 3 global health status/quality of life scales and 2 single items. A preliminary cross-sectional study enrolling all the patients currently cared at the same hospital was carried out. Exclusion criteria were age ≥ 60 years and hospitalization at time of assessment. Thirty-three home parenteral nutrition patients (100% answered) and 22 intestinal transplant recipients (82% answered) were enrolled. Intestinal transplant recipients showed a better score in following scales: ability to holiday/travel (p < 0.001), fatigue (p = 0.022), gastrointestinal symptoms (p < 0.001), stoma management/bowel movements (p = 0.001) and global health status/quality of life (p = 0.012). A better score for ability to eat/drink (p = 0.070) and a worse score for sleep pattern (p = 0.100) after intestinal transplantation were also observed. The results of this preliminary study with specific instruments were consistent with the main expected improvement of the quality of life related to intestinal transplantation. Further studies in larger patient cohorts are required to confirm these data.

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Survival of Patients Identified as Candidates for Intestinal Transplantation: A 3-Year Prospective Follow-Up

Cited by 102 publications

References 27 publications

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Assessment of Quality of Life on Home Parenteral Nutrition and After Intestinal Transplantation Using Treatment-Specific Questionnaires

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