Infectious Morbidity and Mortality in Small Intestine Transplantation: A Decade of Experience
Recommended Citation
Saleem A, Samad M, Khaliq I, Ilyas O, Farah B, Alomari A, Faisal MS, Abusuliman M, Omeish H, Jafri S. Infectious Morbidity and Mortality in Small Intestine Transplantation: A Decade of Experience. Am J Transplant 2025; 25(8):S845.
Document Type
Conference Proceeding
Publication Date
8-1-2025
Publication Title
Am J Transplant
Abstract
Purpose: Small intestine transplant (SIT) is a life-saving procedure for patients with intestinal failure; however, long-term success is challenged by post-transplant infections due to immunosuppressive therapy. Despite advancements in transplantation, SIT recipients remain at high risk for infectious complications significantly impacting morbidity and mortality. Identifying patterns of infection and survival outcomes in these patients is critical for optimizing post-transplant care and developing targeted preventive strategies. This study aims to evaluate the incidence, timing, and mortality associated with infectious complications in SIT recipients, providing insight into the most vulnerable periods and the need for enhanced surveillance and intervention. Methods: A retrospective cohort study was conducted at a single urban quaternary care center in the Midwestern United States, analyzing 27 SIT recipients from 2012 to 2022. Data collected included age at transplant, sex, and causal organisms of infection. Patients were stratified into three groups based on the onset of infection: within six months, 6-12 months, and beyond 12 months post-transplant. Primary outcomes included one- and three-year survival rates. Results: The cohort included 27 patients (62% female, mean age 49 years). Intra-abdominal infections were the most common (29.6%, n=8), with 88% occurring within six months, yielding an 86% one- and three-year survival. CMV viremia (19%) occurred mostly beyond 12 months (80%), with a 100% three-year survival; however, cases arising within 6-12 months had 0% survival at three years. Pneumonia (15%) primarily developed within six months, with 100% three-year survival, except for one case (6-12 months) with no survival at three years. Upper respiratory and skin infections accounted for 7.4% and 11.1% of cases, respectively, both demonstrating favorable three-year survival except for late-onset skin infections (6-12 months), which had 0% survival at three years. Conclusions: Intra-abdominal infections were the most frequent and occurred predominantly within six months post-SIT. CMV viremia, while the second most common, showed variable outcomes based on timing. Larger multicenter studies are needed to better characterize infectious risks and optimize post-SIT management. CITATION INFORMATION: Saleem A., Samad M., Khaliq I., Ilyas O., Farah B., Alomari A., Faisal M., Abusuliman M., Omeish H., Jafri S. Infectious Morbidity and Mortality in Small Intestine Transplantation: A Decade of Experience AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: A. Saleem: None.
Volume
25
Issue
8
First Page
S845
