An Evaluation of Infections and Outcomes Following Intestinal Transplantation

Document Type

Conference Proceeding

Publication Date

10-25-2023

Publication Title

Am J Gastroenterol

Abstract

Introduction: The study aims to analyze the infectious complications and mortality associated with small intestine transplant (SIT) patients on immunosuppressive therapy. Methods: A retrospective cohort study was conducted at a single, urban quaternary care center in midwestern United States and consisted of 27 patients receiving immunotherapy following SIT from 2012-2022. Data points that were collected included age at transplant, sex, and causal organism of infection. Patients were categorized into 3 groups based on onset of infection (within 6/6-12 months/beyond 12 months of transplant). Primary outcomes collected from each group were percent survival at 1 and 3 years respectively. Results: 27 patients were included in the study. The most common source of post SIT infection was intrabdominal which comprised of 29.6% (n=8) of all infections. From this group, 88% developed infections within 6 months of SIT with a 1 and 3-year survival rate of 86% respectively. 13% developed after 12 months, having a 100% survival rate after 1 and 3 years respectively. The second most common source was CMV viremia which comprised 19% of infections with 20% of these patients developing within 6-12 months from SIT with a 1-year survival of 100% and 3-year survival of 0%. From patients who developed CMV viremia, 80% of them developed it after 12 months from SIT, and survival rate at 3 years was 100%. The next group of infections was pneumonia which comprised of 15% of patients (n=4). 75% (n=3) developed within 6 months of SIT and 3-year survival rate was 100%. 25% (n=1) of them developed 6-12 months after SIT and had a 1-year survival rate of 100% with a 3-year survival rate of 0%. Conclusion: Of patients who developed post SIT infections, intrabdominal infections were the most common with most patients developing them within 6 months from SIT. Common causes from this group included intraabdominal abscess’, fluid translocation, peritonitis, and enteritis. While CMV viremia was the second most common infection, the source and site of infection was largely unknown and could have had overlap from patient’s with intrabdominal infection. Larger studies from multi center are needed for further investigation of infectious complications following SIT.

Volume

118

Issue

10

First Page

S1332

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