An overview of EU and USA intestinal transplant current activity
| Autor: | A. Lauro, F. Panaro, K.R. Iyer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Short Bowel Syndrome
Pediatrics medicine.medical_specialty États-Unis d’Amérique Medical rehabilitation Évolution Outcomes 030230 surgery Eu countries Waiting list mortality 03 medical and health sciences 0302 clinical medicine Transplantation d’intestin Outcome Assessment Health Care medicine Member state Long term outcomes Humans Socioeconomic status USA business.industry Registre des transplantations intestinales General Medicine Organ Transplantation Intestinal transplantation United States Europe Europe (EU) Transplantation Intestines Family medicine Quality of Life 030211 gastroenterology & hepatology business |
| Popis: | Summary Aim of the study To report the current activity of intestinal transplantation in Europe (EU) and Unites States of America (USA), underlining outcomes in the last 5 years and discussing possible trends. Patients and methods Data review of results was performed through analysis of ITR and UNOS registries, Eurotransplant and newsletter transplant reports, congress abstracts, international published literature, personal communications and hospital web sites. Results The absence in Europe of a sole organization collecting donors and the presence of many low-volume centers (less than 5 cases/year) makes the difference with USA: in the last 5 years (2010–2014), 222 intestinal/multivisceral transplants have been performed in EU countries (most of them in the UK), while in USA, the number of transplants achieved 634 procedures in the same period of time. Waiting list mortality remains unacceptable in both continents. Improved short-term results, with over 80% survival at 1 year, have been achieved in the busiest transplant centers likely due to immune-induction agents, more recently to innovative cross match strategies and optimizing organ allocation, but long term outcomes are still inferior to other organ transplants. Most long-term survivors were reintegrated to society with self-sustained socioeconomic status. The economic burden for the society is high and related costs are different between USA and EU (and inside Europe between member state's health-care systems), but cost-effectiveness for intestinal transplantation still needs to be proved. Conclusion Overall intestinal transplantation continues to develop in EU and USA together with surgical and medical rehabilitation of patients affected by short gut syndrome. |
| Databáze: | OpenAIRE |
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