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Fifteen years' experience of intestinal and multivisceral transplantation in the Nordic countries

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  • Jonas Varkey
  • Magnus Simrén
  • Hannu Jalanko
  • Mihai Oltean
  • Robert Saalman
  • Audur Gudjonsdottir
  • Markus Gäbel
  • Helena Borg
  • Mats Edenholm
  • Oystein Bentdal
  • Steffen Husby
  • Michael Staun
  • Heikki Mäkisalo
  • Ingvar Bosaeus
  • Michael Olausson
  • Mikko Pakarinen
  • Gustaf Herlenius
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OBJECTIVE: Intestinal and multivisceral transplantation have gained acceptance as treatment modalities for patients with: intestinal failure and life-threatening complications of parenteral nutrition (PN), rare cases of vascular abdominal catastrophes and selected cases of low-grade neoplastic tumors such as neuroendocrine pancreatic tumors and desmoids involving the mesenteric root. The aim was to describe the survival and nutritional outcome in the transplanted Nordic patients and the complications attributed to this procedure.

METHOD: The authors included all Nordic patients transplanted between January 1998 and December 2013. Information on patients transplanted outside the Nordic region was collected through questionnaires.

RESULTS: A total of 34 patients received different types of intestinal allografts. Currently, there are two Nordic transplant centers (n = 29) performing these procedures (Gothenburg, Sweden n = 24, Helsinki, Finland n = 5). The remaining five patients were transplanted in the USA (n = 3) and the UK (n = 2). Most patients were transplanted for life-threatening failure of PN (70%) caused primarily by intestinal motility diseases (59%). Allograft rejection was the most common complication and occurred in 79% of the patients followed by post-transplantation lymphoproliferative disorders (21%) and graft-versus-host disease (18%). The 1- and 5-year survival was 79% and 65% respectively for the whole cohort and nutritional autonomy was achieved in 73% of the adults and 57% of the children at 1 year after transplantation.

CONCLUSION: This collective Nordic experience confirms that intestinal transplantation is a complex procedure with many complications, yet with the possibility to provide long-term survival in selected conditions previously considered untreatable.

Original languageEnglish
JournalScandinavian Journal of Gastroenterology
Volume50
Issue number3
Pages (from-to)278-90
Number of pages13
ISSN0036-5521
DOIs
Publication statusPublished - Mar 2015

    Research areas

  • Adolescent, Adult, Aged, Cause of Death, Child, Child, Preschool, Female, Graft Rejection, Graft Survival, Graft vs Host Disease, Humans, Immunosuppressive Agents, Intestinal Diseases, Intestines, Liver Transplantation, Male, Middle Aged, Parenteral Nutrition, Postoperative Complications, Scandinavian and Nordic Countries, Young Adult

ID: 45955323