intestine transplant registry report · ita registry report 2011 sept 16, 2011 v1 overall clinical...
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Intestine Transplant Registry Report
Intestine Transplant Association A section of the Transplantation Society
Washington, DC September 15 – 18, 2011
ITA Registry Report 2011 Sept 16, 2011 v1
Overall Clinical Experience
Total Number of Transplants: 2611
Centre Count 79 Active Centres 35
SB Alone 1148 (43.9%)
SB+Liver 845 (32.4%)
Multivisceral 619 (23.7%)
Current Survivors 1341
ITA Registry Report 2011 Sept 16, 2011 v1
Transplant Centres Worldwide
N=79
ITA Registry Report 2011 Sept 16, 2011 v1
Active Transplant Centres
N=35
0
20
40
60
80
100
120
140
1985 1990 1995 2000 2005 2010
Children
0
20
40
60
80
100
120
140
1985 1990 1995 2000 2005 2010
Adults
Intestinal Transplants Performed
Year
Tran
spla
nts
Per
form
ed W
orld
wid
e
* *
*Preliminary 2011
ITA Registry Report 2011 Sept 16, 2011 v1
Transplant Activity Worldwide
Ove
rall
Tran
spla
nts
Per
form
ed
'96-'00
'01-'05
'06-'10
0
200
400
600
800
1000
North America Europe
Asia South
America
ITA Registry Report 2011 Sept 16, 2011 v1
Case Volume in 78 Centres (n=2611)
0
100
200
300
400
500
600
Each center is represented by one column showing its total case volume
Tran
spla
nts
Per
form
ed p
er C
entre
ITA Registry Report 2011 Sept 16, 2011 v1
Transplant Type over Time
0%
20%
40%
60%
80%
100%
1985 1990 1995 2000 2005 2010
Small Bowel SB+Liver MVT Full MVT Modified
Pre-Tx Status Over Time
'85-'95 '96-'00 '01-'06 '06-'11
0%
20%
40%
60%
80%
100%
'85-'95 '96-'00 '01-'06 '06-'11
Children Adults
ITA Registry Report 2011 Sept 16, 2011 v1
Median LOS Over Time
0
20
40
60
80
100
120
140
160
1985 1990 1995 2000 2005 2010
Year
Hos
pita
lizat
ion
(Day
s)
Patient Survival by Era
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=1351
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=1012
Children Adults
Graft Survival by Era Children Adults
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=1351
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=1021
0%
Mucosal Defects
10%
Motility 19%
Tumor 0% Re-transplant 8%
Volvulus 13%
Gastrochisis 25%
Trauma 1%
N. Enterocolitis
15%
Ischemia 1%
Crohn's 0%
Atresia 8%
Short Gut 63%
Causes for Transplantation in Current Era (Children)
0% Mucosal Defects
2%
Motility 15%
Tumor 8%
Re-transplant 10%
Volvulus 11%
Gastrochisis 7%
Trauma 6%
N. Enterocolitis
2%
Ischemia 24%
Crohn's 13%
Atresia 2%
Short Gut 65%
Causes for Transplantation in Current Era (Adults)
Patient Survival by Graft Type (2006-2011)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72
Surv
ival
%
Months
n=531
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72
Surv
ival
%
Months
n=624
Children Adults
Graft Survival by Graft Type (2006-2011)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72
Surv
ival
%
Months
n=624
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72
Surv
ival
%
Months
n=531
Children Adults
Conditional* Graft Survival by Era
* This analysis starts after 1 yr of graft survival.
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=796
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
Surv
ival
%
Months
n=598
Children Adults
ITA Registry Report 2011 Sept 16, 2011 v1
Multiple Variable Regression Analysis: Preliminary Results
End-point Predictor HR* P value
Graft Survival 2006-11
Age < 1 yr 1.23 0.04
Top 40% program case volume
0.66 0.02
Home 0.68 0
Conditional graft survival (all eras)
+ Liver component 0.68 0
* Lower ratio = improved survival
ITA Registry Report 2011 Sept 16, 2011 v1
Conditional Long Term Survival by Transplant Type
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 24 48 72 96 120 144 168 192 216 240
S(x)
Months
MVT Full MVT modified SBliv SBt
n=1398