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Intestine

OPTN/SRTR 2016 Annual Data Report: Intestine

Abstract

Despite improvements in medical and surgical treatment of intestinal failure, intestine transplant continues to play an important role. In 2016, a total of 147 intestine transplants were performed, 80 intestine-without-liver and 67 intestine-liver. Over the past decade, the age distribution of candidates waitlisted for intestine and intestine-liver transplant shifted from primarily pediatric to increasing proportions of adults. In 2016, 58.2% of candidates on the intestine list at any time during the year were aged younger than 18 years, with a decrease over time in those aged younger than 6 years and an increase in those aged 6-17 years. Adults accounted for 41.9% of candidates on the list at any time during the year, with a stable proportion of those aged 18-34 years and a decrease in those aged 35 years or older. By age, pretransplant mortality rate was highest for adult candidates at 11.7 per 100 waitlist years and lowest for children aged younger than 6 years at 2.2 per 100 waitlist years. For intestine transplants with or without a liver in 2009-2011, 1- and 5-year graft survival was 72.0% and 54.1%, respectively, for recipients aged younger than 18 years, and 70.5% and 44.1%, respectively, for recipients aged 18 years or older.

Introduction

Advances in the medical and surgical treatments of intestinal failure have led to a decrease in the number of transplants over the past decade. Patient survival has improved, and morbidity associated with parenteral nutrition, including liver failure, has declined. Nevertheless, intestine transplant still plays an important role in the treatment of intestinal failure. Intestine transplants may be performed in isolation, with a liver transplant, or as part of a multi-visceral transplant including any combination of liver, stomach, pancreas, colon, spleen, and kidney. There are notable differences in patients and transplant outcomes for intestine transplants with and without liver. Information on the waiting list, transplants, and outcomes is presented for both types of transplants.

Waiting List

In 2016, 195 patients were added to the intestine transplant waiting list, with similar numbers waiting for intestine (98) and for intestine-liver (97) transplant (Figure IN 1). Among the 270 prevalent patients on the waiting list at the end of 2016, 163 (60.4%) were waiting for intestine transplant and 107 (39.6%) were waiting for intestine-liver transplant (Figure IN 2, Table IN 4). Over the past decade, the age distribution of candidates waitlisted for intestine and intestine-liver transplant shifted from primarily pediatric to increasing proportions of adults (Figure IN 3). In 2016, 58.2% of candidates on the intestine waiting list were aged younger than 18 years, with a decrease over time in those aged younger than 6 years and an increase in those aged 6-17 years. Adults account for 41.9% of candidates on the list, with a stable proportion of those aged 18-34 years and a decrease in those aged 35 years or older. The racial/ethnic distribution did not change (Figure IN 4). The most common etiology of intestinal failure remained short-gut syndrome (SGS; 55.9%), which encompasses a large group of diagnoses (Figure IN 5). In 2016, 51.5% of candidates were on the waiting list for less than 1 year, 14.8% for 1 to less than 2 years, and 33.7% for 2 or more years (Figure IN 6).

Characteristics of intestine and intestine-liver candidates on the waiting list at year end 2016 were similar with respect to age, sex, and race (Table IN 1). Considering disease etiology, pseudo-obstruction, necrotizing enterocolitis, and non-congenital SGS were more common among candidates listed for intestine transplant and enteropathies were more common among intestine-liver candidates (Table IN 2). Intestine-liver candidates were more often status 1 than candidates for intestine without liver (59.8% vs. 32.5%). Listing for retransplant was more common among intestine-liver candidates than among intestine candidates (Table IN 3). Transplant rates and trends varied by candidate age and transplant type (intestine, intestine-liver) (Figure IN 9). In 2016, transplant rates were highest for adult intestine-without-liver transplants, at 190.6 per 100 waitlist years, and lowest for pediatric intestine without liver transplant, at 23.5 per 100 waitlist years. The transplant rate was 127.2 per 100 waitlist years for adult intestine-liver candidates and 64.3 per 100 waitlist years for pediatric intestine-liver candidates.

Of the 90 candidates removed from the intestine-without-liver waiting list in 2016, 77 (85.6%) underwent deceased donor transplant, 4 died, 3 were removed from the list because their condition improved, and 1 was considered too sick to undergo transplant (Table IN 5). Of the 94 candidates removed from the intestine-liver waiting list, 70 (74.5%) underwent deceased donor transplant, 9 died, 5 were removed from the list because their condition improved, and 6 were considered too sick to undergo transplant. Regarding 3-year outcomes, 67.5% of intestine transplant candidates listed in 2013 underwent deceased donor transplant, 3.9% died, 6.5% were removed from the list, and 22.1% were still waiting in 2016 (Figure IN 10). Of intestine-liver candidates listed in 2013, 58.3% underwent deceased donor transplant, 22.9% died, 15.6% were removed from the list, and 3.1% were still waiting in 2016 (Figure IN 11). Among candidates listed in 2015-2016, median time to transplant was 5.6 months for adult and 6.8 months for pediatric intestine-liver transplant candidates, and 2.6 months for adult intestine transplant candidates (Figure IN 12). The median was not observed for pediatric intestine transplant candidates; the median for those listed in 2009-2010 was 25.0 months.

Among candidates on the waiting list in 2015-2016, by age, pretransplant mortality was highest for adults at 11.7 per 100 waitlist years and lowest for children aged younger than 6 years at 2.2 per 100 waitlist years (Figure IN 13). Regarding age and type of transplant, pretransplant mortality was highest for adult intestine-liver and lowest for pediatric intestine candidates (respectively, 21.1 vs. 0.9 deaths per 100 waitlist years in 2015-2016) (Figure IN 16). Pretransplant mortality was similar for the different etiologies of organ failure (Figure IN 15).

Donation

The largest proportion of intestine donors were aged 18-34 years (34.8%), and the next largest proportion were aged younger than 5 years (32.9%) (Figure IN 17). Most intestine donors were white (62.6%, Figure IN 18). The overall rate of intestines recovered for transplant and not transplanted was 8.0% in 2015-2016 (Figure IN 20). The most common cause of death among deceased intestine donors has been head trauma, 54.4% in 2016 (Figure IN 22).

Transplant

In 2016, a total of 147 intestine transplants were performed, 80 intestine and 67 intestine-liver (Figure IN 23). In 2016, six programs were performing intestine transplants primarily in children, six were performing transplants only in adults, and seven were performing transplants in both adults and children (Figure IN 34). The median program volume was six intestine transplants per year in 2016, down from a median of 12 in 2015.(Figure IN 35). In 2016, 59.6% of intestine transplants were performed at programs in the 75th-95th percentile of volume, 26-54 transplants per year (Figure IN 36, Figure IN 35).

The age distribution of intestine and intestine-liver transplant recipients changed substantially over the past decade, with adult recipients now outnumbering pediatric recipients (Figure IN 24). Comparing intestine with intestine-liver transplant recipients, more than half of intestine-liver transplant recipients were aged younger than 18 years (52.2%) versus 27.5% of intestine recipients (Table IN 6). SGS (congenital and non-congenital) was the main cause of disease leading to both intestine and intestine-liver transplant (Table IN 7). The proportion of recipients who waited a year or more for an intestine transplant without a liver was 18.8%, compared with 12.0% for intestine-liver recipients (Table IN 8). In 2016, 20.9% of intestine-liver transplant recipients had undergone a previous intestine transplant, compared with 7.5% of intestine transplant recipients.

Immunosuppression

Regarding induction therapy in 2016, 52.9% of intestine transplant recipients, with and without a liver, received T-cell depleting agents, 16.2% received interleukin-2 receptor antagonists, and 34.6% reported no induction (Figure IN 28). The initial immunosuppression agents used most commonly in 2016 were tacrolimus (97.8%, Figure IN 29), steroids (73.5%, Figure IN 32), and mycophenolate (38.2%, Figure IN 30).Steroids were used in 80.2% of recipients who underwent transplant in 2015 at 1 year posttransplant (Figure IN 32).

Outcomes

Graft failure has declined since the late 1990s, but plateaued over the past decade. The age-, sex-, and race-adjusted graft failure rate among intestine transplant recipients was 16.1% at 6 months, and 22.0% at 1 year for transplants in 2014-2015, 43% at 3 years for transplants in 2012-2013, 51.3% at 5 years for transplants in 2010-2011, and 71.2% at 10 years for transplants in 2004-2005 (Figure IN 37). Among intestine-liver transplant recipients, the graft failure rate was 19.8% at 6 months, and 28% at 1 year for transplants in 2014-2015, 36.7% at 3 years for transplants in 2012-2013, 44.9% at 5 years for transplants in 2010-2011, and 52.7% at 10 years for transplants in 2004-2005 (Figure IN 38). For intestine transplants in 2009-2011, Figure IN 39 shows 5-year graft survival curves by recipient age and Figure IN 40 shows survival by organ transplanted. For intestine transplants with or without a liver in 2009-2011, 1- and 5-year graft survival was 72.0% and 54.1%, respectively, for recipients aged younger than 18 years, and 70.5% and 44.1%, respectively, for recipients aged 18 years or older. One- and 5-year graft survival was 70.9% and 47.6%, respectively, for recipients of intestines without a liver, and 70.2% and 50.6%, respectively, for intestine-liver recipients. The number of recipients alive with a functioning intestine graft steadily increased over time to 1158 on July 1, 2016; 42.3% were pediatric intestine-liver transplant recipients (Figure IN 41). The incidence of first acute rejection in the first posttransplant year varied by era, age group, and transplant procedure. Among recipients in 2014-2015; incidence was highest in pediatric recipients of intestine without liver (65.7%) and lowest in adult intestine-liver recipients (29.7%) (Figure IN 42). For recipients who underwent transplant in 2004-2014, 9.2% of intestine-without-liver recipients (Figure IN 43) and 7% of intestine-liver recipients (Figure IN 44) developed posttransplant lymphoproliferative disorder within 5 years posttransplant. Incidence was highest among recipients who were negative for Epstein-Barr virus (EBV): 10.6% of EBV-negative intestine-without-liver recipients and 7.8% of EBV-negative intestine-liver recipients. Patient survival varied by age and type of transplant. Patient survival was lowest for adult intestine-liver recipients (1- and 5-year survival 66.1% and 40.3%, respectively) and highest for pediatric intestine recipients (1- and 5-year survival 82.3% and 67.7%, respectively) (Figure IN 45).

Figure List

Waiting list

Figure IN 1. New candidates added to the intestine transplant waiting list
Figure IN 2. Candidates listed for intestine transplant on December 31 each year
Figure IN 3. Distribution of candidates waiting for intestine transplant by age
Figure IN 4. Distribution of candidates waiting for intestine transplant by race
Figure IN 5. Distribution of candidates waiting for intestine transplant by diagnosis
Figure IN 6. Distribution of candidates waiting for intestine transplant by waiting time
Figure IN 7. Distribution of candidates waiting for intestine transplant by medical urgency
Figure IN 8. Distribution of candidates waiting for intestine transplant by liver co-listing
Figure IN 9. Deceased donor intestine transplant rates among active waitlist candidates by age and liver co-listing
Figure IN 10. Three-year outcomes for candidates waiting for intestine transplant without liver, new listings in 2013
Figure IN 11. Three-year outcomes for candidates waiting for intestine transplant with liver, new listings in 2013
Figure IN 12. Median months to intestine transplant for waitlist candidates by age
Figure IN 13. Pretransplant mortality rates among candidates waitlisted for intestine transplant by age
Figure IN 14. Pretransplant mortality rates among candidates waitlisted for intestine transplant by race
Figure IN 15. Pretransplant mortality rates among candidates waitlisted for intestine transplant by diagnosis
Figure IN 16. Pretransplant mortality rates among candidates waitlisted for intestine transplant by liver co-listing

Deceased donation

Figure IN 17. Deceased intestine donors by age
Figure IN 18. Deceased intestine donors by race
Figure IN 19. Rates of intestines recovered for transplant and not transplanted by age
Figure IN 20. Rates of intestines recovered for transplant and not transplanted by sex
Figure IN 21. Rates of intestines recovered for transplant and not transplanted by race
Figure IN 22. Cause of death among deceased intestine donors

Transplant

Figure IN 23. Total intestine transplants
Figure IN 24. Total intestine transplants by age
Figure IN 25. Total intestine transplants by sex
Figure IN 26. Total intestine transplants by race
Figure IN 27. Total intestine transplants by diagnosis
Figure IN 28. Induction agent use in intestine transplant recipients
Figure IN 29. Calcineurin inhibitor use in intestine transplant recipients
Figure IN 30. Anti-metabolite use in intestine transplant recipients
Figure IN 31. mTOR inhibitor use in intestine transplant recipients
Figure IN 32. Steroid use in intestine transplant recipients
Figure IN 33. Total HLA A, B, and DR mismatches among adult deceased donor intestine transplant recipients, 2012-2016
Figure IN 34. Number of centers performing adult and pediatric and adult intestine transplants by center's age mix
Figure IN 35. Annual adult intestine transplant center volumes, by percentile
Figure IN 36. Distribution of adult intestine transplants by percentile of center volume

Outcomes

Figure IN 37. Graft failure among transplant recipients of intestine without liver
Figure IN 38. Graft failure among transplant recipients of intestine with liver
Figure IN 39. Graft survival among intestine transplant recipients, 2009-2011, by age
Figure IN 40. Graft survival among adult deceased donor intestine transplant recipients, 2011, by transplant type
Figure IN 41. Recipients alive with a functioning intestine graft on June 30 of the year, by age at transplant and procedure
Figure IN 42. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by age and transplant type
Figure IN 43. Incidence of PTLD among recipients of intestine transplant without liver by recipient EBV status at transplant, 2004-2014
Figure IN 44. Incidence of PTLD among recipients of intestine transplant with liver by recipient EBV status at transplant, 2004-2014
Figure IN 45. Patient survival among adult deceased donor intestine transplant recipients, 2009-2011, by age and transplant type

Table List

Waiting list

Table IN 1. Demographic characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Table IN 2. Clinical characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Table IN 3. Listing characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Table IN 4. Intestine transplant waitlist activity, 2016
Table IN 5. Removal reason among intestine transplant candidates, 2016

Transplant

Table IN 6. Demographic characteristics of intestine transplant recipients, 2016
Table IN 7. Clinical characteristics of intestine transplant recipients, 2016
Table IN 8. Transplant characteristics of intestine transplant recipients, 2016

A line plot for new candidates added to the intestine transplant waiting list; the in category is 96 candidates at 2005 and remains relatively constant with a value of 98 candidates at 2016; the in to li category decreases by 44.9% from 176 candidates at 2005 to 97 candidates at 2016; and the all category decreases by 28.3% from 272 candidates at 2005 to 195 candidates at 2016.

Figure IN 1. New candidates added to the intestine transplant waiting list
A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates concurrently listed at multiple centers are counted once. Active and inactive patients are included. New intestine-liver candidates are those listed for both organs on the same day. IN, intestine without liver; IN-LI, intestine-liver.


A line plot for candidates listed for intestine transplant on december 31 each year; the in category increases by 73.4% from 94 candidates at 2005 to 163 candidates at 2016; the in to li category is 102 candidates at 2005 and remains relatively constant with a value of 107 candidates at 2016; and the all category increases by 37.8% from 196 candidates at 2005 to 270 candidates at 2016.

Figure IN 2. Candidates listed for intestine transplant on December 31 each year
Candidates concurrently listed at multiple centers are counted once. Those with concurrent listings and active at any program are considered active. IN, intestine without liver; IN-LI, intestine-liver.


A line plot for distribution of candidates waiting for intestine transplant by age; the  less than  6 category decreases by 34.4% from 53.1 percent at 2005 to 34.8 percent at 2016; the 6 to 17 category increases by 55.0% from 15.1 percent at 2005 to 23.3 percent at 2016; the 18 to 34 category increases by 11.7% from 12.2 percent at 2005 to 13.7 percent at 2016; and the  greater than or equal to 35 category increases by 43.5% from 19.7 percent at 2005 to 28.2 percent at 2016.

Figure IN 3. Distribution of candidates waiting for intestine transplant by age
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Age is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.


A line plot for distribution of candidates waiting for intestine transplant by race; the white category is 62.4 percent at 2005 and remains relatively constant with a value of 57.9 percent at 2016; the black category is 18.8 percent at 2005 and remains relatively constant with a value of 19.4 percent at 2016; the hispanic category increases by 12.4% from 15.3 percent at 2005 to 17.2 percent at 2016; the asian category increases by 34.5% from 2.6 percent at 2005 to 3.5 percent at 2016; and the other/unknown category increases by 127.0% from 0.9 percent at 2005 to 2 percent at 2016.

Figure IN 4. Distribution of candidates waiting for intestine transplant by race
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Active and inactive candidates are included.


A line plot for distribution of candidates waiting for intestine transplant by diagnosis; the necrotizing enterocolitis category decreases by 33.7% from 14.6 percent at 2005 to 9.7 percent at 2016; the congenital sgs category decreases by 12.2% from 21.8 percent at 2005 to 19.2 percent at 2016; the non to congenital sgs category increases by 37.0% from 26.9 percent at 2005 to 36.8 percent at 2016; the pseudo to obstruction category decreases by 14.9% from 7 percent at 2005 to 5.9 percent at 2016; the enteropathies category increases by 87.4% from 1.5 percent at 2005 to 2.9 percent at 2016; and the other/unknown category is 28.2 percent at 2005 and remains relatively constant with a value of 25.6 percent at 2016.

Figure IN 5. Distribution of candidates waiting for intestine transplant by diagnosis
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Active and inactive patients are included. SGS, short-gut syndrome.


A line plot for distribution of candidates waiting for intestine transplant by waiting time; the  less than  1 year category decreases by 28.9% from 72.5 percent at 2005 to 51.5 percent at 2016; the 1 to less than  2 category increases by 30.0% from 11.4 percent at 2005 to 14.8 percent at 2016; the 2 to less than  3 category increases by 113.0% from 3.9 percent at 2005 to 8.4 percent at 2016; the 3 to less than  4 category increases by 51.3% from 3.1 percent at 2005 to 4.6 percent at 2016; the 4 to less than  5 category increases by 303.5% from 1.1 percent at 2005 to 4.4 percent at 2016; and the  greater than or equal to  5 category increases by 101.8% from 8.1 percent at 2005 to 16.3 percent at 2016.

Figure IN 6. Distribution of candidates waiting for intestine transplant by waiting time
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Time on the waiting list is determined at the earlier of December 31 or removal from the waiting list. Active and inactive candidates are included.


A line plot for distribution of candidates waiting for intestine transplant by medical urgency; the status 1 category decreases by 16.4% from 71.4 percent at 2005 to 59.7 percent at 2016; the non to urgent category increases by 42.8% from 19.4 percent at 2005 to 27.8 percent at 2016; and the inactive category increases by 36.9% from 9.2 percent at 2005 to 12.6 percent at 2016.

Figure IN 7. Distribution of candidates waiting for intestine transplant by medical urgency
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Medical urgency status is the most severe during the year. Active and inactive patients are included.


A line plot for distribution of candidates waiting for intestine transplant by liver co-listing; the in category increases by 37.4% from 40.4 percent at 2005 to 55.5 percent at 2016; and the in to li category decreases by 25.4% from 59.6 percent at 2005 to 44.5 percent at 2016.

Figure IN 8. Distribution of candidates waiting for intestine transplant by liver co-listing
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Intestine-liver (IN-LI) candidates were dually listed on at least one day during the year. Active and inactive patients are included.


A line plot for deceased donor intestine transplant rates among active waitlist candidates by age and liver co-listing; the in, age  less than  18 category decreases by 54.8% from 52 transplants per 100 waitlist years at 2005 to 23.5 transplants per 100 waitlist years at 2016; the in, age  greater than or equal to  18 category decreases by 33.6% from 287 transplants per 100 waitlist years at 2005 to 190.6 transplants per 100 waitlist years at 2016; the in to li, age  less than  18 category decreases by 43.3% from 113.3 transplants per 100 waitlist years at 2005 to 64.3 transplants per 100 waitlist years at 2016; and the in to li, age  greater than or equal to  18 category decreases by 35.9% from 198.4 transplants per 100 waitlist years at 2005 to 127.2 transplants per 100 waitlist years at 2016.

Figure IN 9. Deceased donor intestine transplant rates among active waitlist candidates by age and liver co-listing
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active waiting in a given year. Individual listings are counted separately. Intestine-liver co-listing is computed in a time-dependent manner. Rates with less than 10 patient-years of exposure are not shown.


A line plot for three-year outcomes for candidates waiting for intestine transplant without liver, new listings in 2013; the still waiting category decreases by 77.9% from 100 percent at 0 Months postlisting to 22.1 percent at 36 Months postlisting; the removed from list category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; the died category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; and the dd transplant category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting.

Figure IN 10. Three-year outcomes for candidates waiting for intestine transplant without liver, new listings in 2013
Candidates waiting for intestine transplant and first listed in 2013. Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. DD, deceased donor.


A line plot for three-year outcomes for candidates waiting for intestine transplant with liver, new listings in 2013; the still waiting category decreases by 96.9% from 100 percent at 0 Months postlisting to 3.1 percent at 36 Months postlisting; the removed from list category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; the died category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; and the dd transplant category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting.

Figure IN 11. Three-year outcomes for candidates waiting for intestine transplant with liver, new listings in 2013
Candidates waiting for intestine-liver transplant and first listed in 2013. Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. DD, deceased donor.


A line plot for median months to intestine transplant for waitlist candidates by age; the age less than 18,in category increases by 72.6% from 14.5 months at 2005-2006 to 25 months at 2009-2010; the age greater than or equal to 18,in category is 2.7 months at 2005-2006 and remains relatively constant with a value of 2.6 months at 2015-2016; the age less than 18, in to li category decreases by 64.7% from 19.3 months at 2005-2006 to 6.8 months at 2015-2016; the age greater than or equal to 18, in to li category increases by 21.4% from 4.6 months at 2005-2006 to 5.6 months at 2015-2016; and the all category decreases by 29.9% from 7.9 months at 2005-2006 to 5.6 months at 2015-2016.

Figure IN 12. Median months to intestine transplant for waitlist candidates by age
Observations censored on December 31, 2016; Kaplan-Meier competing risk methods used to estimate time to transplant. Analysis performed per candidate, not per listing. If an estimate is not plotted, 50% of the cohort listed in that year had not undergone transplant by the censoring date. Only the first transplant is counted.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by age; the  less than  6 category decreases by 92.8% from 30.4 deaths per 100 waitlist years at 2005-2006 to 2.2 deaths per 100 waitlist years at 2015-2016; the 6 to 17 category decreases by 59.5% from 10.4 deaths per 100 waitlist years at 2005-2006 to 4.2 deaths per 100 waitlist years at 2015-2016; the  greater than or equal to  18 category decreases by 60.0% from 29.3 deaths per 100 waitlist years at 2005-2006 to 11.7 deaths per 100 waitlist years at 2015-2016; and the all category decreases by 77.2% from 25.5 deaths per 100 waitlist years at 2005-2006 to 5.8 deaths per 100 waitlist years at 2015-2016.

Figure IN 13. Pretransplant mortality rates among candidates waitlisted for intestine transplant by age
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown. Age is determined at the later of listing date or January 1 of the given year.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by race; the white category decreases by 77.9% from 26.5 deaths per 100 waitlist years at 2005-2006 to 5.8 deaths per 100 waitlist years at 2015-2016; the black category decreases by 71.3% from 28.4 deaths per 100 waitlist years at 2005-2006 to 8.2 deaths per 100 waitlist years at 2015-2016; and the hispanic category decreases by 84.5% from 36.5 deaths per 100 waitlist years at 2005-2006 to 5.7 deaths per 100 waitlist years at 2015-2016.

Figure IN 14. Pretransplant mortality rates among candidates waitlisted for intestine transplant by race
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by diagnosis; the necrotizing enterocolitis category decreases by 89.3% from 31.2 deaths per 100 waitlist years at 2005-2006 to 3.3 deaths per 100 waitlist years at 2015-2016; the congenital sgs category decreases by 82.3% from 32.5 deaths per 100 waitlist years at 2005-2006 to 5.8 deaths per 100 waitlist years at 2015-2016; the non to congential sgs category decreases by 70.4% from 23 deaths per 100 waitlist years at 2005-2006 to 6.8 deaths per 100 waitlist years at 2015-2016; and the other/unknown category decreases by 75.8% from 28.8 deaths per 100 waitlist years at 2005-2006 to 7 deaths per 100 waitlist years at 2015-2016.

Figure IN 15. Pretransplant mortality rates among candidates waitlisted for intestine transplant by diagnosis
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown. SGS, short-gut syndrome.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by liver co-listing; the in, age  less than  18 category decreases by 68.3% from 2.9 deaths per 100 waitlist years at 2005-2006 to 0.9 deaths per 100 waitlist years at 2015-2016; the in, age  greater than or equal to  18 category decreases by 58.7% from 15.6 deaths per 100 waitlist years at 2005-2006 to 6.4 deaths per 100 waitlist years at 2015-2016; the in to li, age  less than  18 category decreases by 83.6% from 48.9 deaths per 100 waitlist years at 2005-2006 to 8 deaths per 100 waitlist years at 2015-2016; and the in to li, age  greater than or equal to  18 category decreases by 58.1% from 50.4 deaths per 100 waitlist years at 2005-2006 to 21.1 deaths per 100 waitlist years at 2015-2016.

Figure IN 16. Pretransplant mortality rates among candidates waitlisted for intestine transplant by liver co-listing
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Intestine-liver co-listing is computed in a time-dependent manner. Rates with less than 10 patient-years of exposure are not shown.


A line plot for deceased intestine donors by age; the  less than  5 category decreases by 27.9% from 45.7 percent at 2005 to 32.9 percent at 2016; the 5 to 17 category is 26.6 percent at 2005 and remains relatively constant with a value of 25.8 percent at 2016; the 18 to 34 category increases by 88.5% from 18.5 percent at 2005 to 34.8 percent at 2016; and the  greater than or equal to  35 category decreases by 30.2% from 9.2 percent at 2005 to 6.5 percent at 2016.

Figure IN 17. Deceased intestine donors by age
Deceased donors whose intestines were recovered for transplant.


A line plot for deceased intestine donors by race; the white category increases by 11.8% from 56 percent at 2005 to 62.6 percent at 2016; the black category increases by 25.0% from 20.7 percent at 2005 to 25.8 percent at 2016; the hispanic category decreases by 59.4% from 20.7 percent at 2005 to 8.4 percent at 2016; and the other/unknown category increases by 18.7% from 2.7 percent at 2005 to 3.2 percent at 2016.

Figure IN 18. Deceased intestine donors by race
Deceased donors whose intestines were recovered for transplant.


A line plot for rates of intestines recovered for transplant and not transplanted by age; the  less than  18 category decreases by 28.3% from 5.4 percent at 2005-2006 to 3.8 percent at 2015-2016; and the  greater than or equal to  18 category increases by 15.9% from 12 percent at 2005-2006 to 14 percent at 2015-2016.

Figure IN 19. Rates of intestines recovered for transplant and not transplanted by age
Percentages of intestines not transplanted out of all intestines recovered for transplant.


A line plot for rates of intestines recovered for transplant and not transplanted by sex; the male category decreases by 12.1% from 8 percent at 2005-2006 to 7 percent at 2015-2016; the female category increases by 44.9% from 6.4 percent at 2005-2006 to 9.3 percent at 2015-2016; and the all category is 7.3 percent at 2005-2006 and remains relatively constant with a value of 8 percent at 2015-2016.

Figure IN 20. Rates of intestines recovered for transplant and not transplanted by sex
Percentages of intestines not transplanted out of all intestines recovered for transplant.


A line plot for rates of intestines recovered for transplant and not transplanted by race; the white category increases by 21.2% from 8.3 percent at 2005-2006 to 10.1 percent at 2015-2016; the black category decreases by 31.6% from 3.7 percent at 2005-2006 to 2.5 percent at 2015-2016; and the other/unknown category is 8.3 percent at 2005-2006 and remains relatively constant with a value of 8.8 percent at 2015-2016.

Figure IN 21. Rates of intestines recovered for transplant and not transplanted by race
Percentages of intestines not transplanted out of all intestines recovered for transplant.


A line plot for cause of death among deceased intestine donors; the anoxia category increases by 38.3% from 21.6 percent at 2005 to 29.9 percent at 2016; the cva/stroke category decreases by 39.7% from 15.8 percent at 2005 to 9.5 percent at 2016; the head trauma category is 59.6 percent at 2005 and remains relatively constant with a value of 54.4 percent at 2016; the cns tumor category is 0 percent at 2005 and is percent at 2016; and the other category increases by 62.9% from 2.9 percent at 2005 to 4.8 percent at 2016.

Figure IN 22. Cause of death among deceased intestine donors
Deceased donors whose intestines were transplanted. CNS, central nervous system; CVA, cerebrovascular accident.


A line plot for total intestine transplants; the in category is 88 transplants at 2005 and remains relatively constant with a value of 80 transplants at 2016; the in to li category decreases by 25.6% from 90 transplants at 2005 to 67 transplants at 2016; and the all category decreases by 17.4% from 178 transplants at 2005 to 147 transplants at 2016.

Figure IN 23. Total intestine transplants
All intestine transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients. IN, intestine without liver; IN-LI, intestine-liver.


A line plot for total intestine transplants by age; the  less than 18 category decreases by 40.6% from 96 transplants at 2005 to 57 transplants at 2016; and the  greater than or equal to 18 category is 82 transplants at 2005 and remains relatively constant with a value of 90 transplants at 2016.

Figure IN 24. Total intestine transplants by age
All intestine transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total intestine transplants by sex; the male category is 82 transplants at 2005 and remains relatively constant with a value of 89 transplants at 2016; and the female category decreases by 39.6% from 96 transplants at 2005 to 58 transplants at 2016.

Figure IN 25. Total intestine transplants by sex
All intestine transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total intestine transplants by race; the white category decreases by 20.7% from 121 transplants at 2005 to 96 transplants at 2016; the black category is 26 transplants at 2005 and remains relatively constant with a value of 24 transplants at 2016; and the other/unknown category decreases by 12.9% from 31 transplants at 2005 to 27 transplants at 2016.

Figure IN 26. Total intestine transplants by race
All intestine transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total intestine transplants by diagnosis; the necrotizing enterocolitis category decreases by 66.7% from 21 transplants at 2005 to 7 transplants at 2016; the congenital sgs category is 24 transplants at 2005 and remains relatively constant with a value of 23 transplants at 2016; the non to congenital sgs category is 79 transplants at 2005 and remains relatively constant with a value of 79 transplants at 2016; the pseudo to obstruction category decreases by 69.6% from 23 transplants at 2005 to 7 transplants at 2016; the enteropathies category decreases by 33.3% from 3 transplants at 2005 to 2 transplants at 2016; and the other/unknown category is 28 transplants at 2005 and remains relatively constant with a value of 29 transplants at 2016.

Figure IN 27. Total intestine transplants by diagnosis
All intestine transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients. SGS, short-gut syndrome.


A line plot for induction agent use in intestine transplant recipients; the il2 to ra category is 15.1 percent at 2005 and remains relatively constant with a value of 16.2 percent at 2016; the t to cell depleting category increases by 41.7% from 37.3 percent at 2005 to 52.9 percent at 2016; and the none category decreases by 29.2% from 48.8 percent at 2005 to 34.6 percent at 2016.

Figure IN 28. Induction agent use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN. IL2-RA, interleukin-2 receptor antagonist.


A line plot for calcineurin inhibitor use in intestine transplant recipients; the cyclosporine category is 0 percent at 2005 and is percent at 2016; and the tacrolimus category is 92.2 percent at 2005 and remains relatively constant with a value of 97.8 percent at 2016.

Figure IN 29. Calcineurin inhibitor use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN.


A line plot for anti-metabolite use in intestine transplant recipients; the azathioprine category is 0 percent at 2005 and is percent at 2016; and the mycophenolate category increases by 217.4% from 12 percent at 2005 to 38.2 percent at 2016.

Figure IN 30. Anti-metabolite use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN. Mycophenolate includes mycophenolate mofetil and mycophenolate sodium.


A line plot for mtor inhibitor use in intestine transplant recipients; the at transplant category decreases by 22.9% from 11.4 percent at 2005 to 8.8 percent at 2016; and the 1 year posttransplant category increases by 41.5% from 16.7 percent at 2005 to 23.6 percent at 2015.

Figure IN 31. mTOR inhibitor use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN. One-year posttransplant data are limited to patients alive with graft function at 1 year posttransplant. mTOR, mammalian target of rapamycin.


A line plot for steroid use in intestine transplant recipients; the at transplant category is 68.1 percent at 2005 and remains relatively constant with a value of 73.5 percent at 2016; and the 1 year posttransplant category increases by 26.3% from 63.5 percent at 2005 to 80.2 percent at 2015.

Figure IN 32. Steroid use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN. One-year posttransplant data are limited to patients alive with graft function at 1 year posttransplant.


A bar plot for total hla a, b, and dr mismatches among adult deceased donor intestine transplant recipients, 2012-2016, the 0 group is 0.16 percent; the 1 group is 0.31 percent; the 2 group is 2.98 percent; the 3 group is 12.23 percent; the 4 group is 25.39 percent; the 5 group is 36.05 percent; the 6 group is 18.03 percent; and the unk. group is 4.86 percent.

Figure IN 33. Total HLA A, B, and DR mismatches among adult deceased donor intestine transplant recipients, 2012-2016
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2016.


A line plot for number of centers performing adult and pediatric and adult intestine transplants by center

Figure IN 34. Number of centers performing adult and pediatric and adult intestine transplants by center's age mix
Adult centers transplanted only recipients aged 18 years or older. Functionally adult centers transplanted 80% adults or more, and the remainder were children aged 15-17 years. Mixed included adults and children of any age groups. Child only centers transplanted recipeints aged 0-17 years, and a small number of adults up to age 21 years.


A line plot for annual adult intestine transplant center volumes, by percentile; the 5th category is 1 transplants per center at 2005 and remains relatively constant with a value of 1 transplants per center at 2016; the 25th category is 3 transplants per center at 2005 and remains relatively constant with a value of 3 transplants per center at 2016; the median category is 6 transplants per center at 2005 and remains relatively constant with a value of 6 transplants per center at 2016; the 75th category is 28.5 transplants per center at 2005 and remains relatively constant with a value of 26 transplants per center at 2016; and the 95th category is 59 transplants per center at 2005 and remains relatively constant with a value of 54 transplants per center at 2016.

Figure IN 35. Annual adult intestine transplant center volumes, by percentile
Annual volume data are limited to recipients aged 18 or older.


A line plot for distribution of adult intestine transplants by percentile of center volume; the  less than or equal to 25th category increases by 37.0% from 3.5 percent at 2005 to 4.8 percent at 2016; the  greater than 25th to 75th category increases by 38.8% from 25.7 percent at 2005 to 35.6 percent at 2016; the  greater than 75th to 95th category increases by 14.2% from 52.2 percent at 2005 to 59.6 percent at 2016; and the  greater than 95th category increases by 36.7% from 18.7 percent at 2005 to 25.5 percent at 2012.

Figure IN 36. Distribution of adult intestine transplants by percentile of center volume
Percentiles are based on annual volume data among recipients aged 18 or older.


A line plot for graft failure among transplant recipients of intestine without liver; the 6 to month category decreases by 49.9% from 32.1 percent at 1998-1999 to 16.1 percent at 2014-2015; the 1 to year category decreases by 45.7% from 40.5 percent at 1998-1999 to 22 percent at 2014-2015; the 3 to year category decreases by 26.9% from 58.7 percent at 1998-1999 to 43 percent at 2012-2013; the 5 to year category decreases by 25.2% from 68.5 percent at 1998-1999 to 51.2 percent at 2010-2011; and the 10 to year category decreases by 10.8% from 79.8 percent at 1998-1999 to 71.2 percent at 2004-2005.

Figure IN 37. Graft failure among transplant recipients of intestine without liver
All recipients of deceased donor intestines, including multi-organ transplants. Patients are followed until the earliest of retransplant, graft failure, death, or December 31, 2016. Estimates computed with Cox proportional hazards models adjusted for age, sex, and race.


A line plot for graft failure among transplant recipients of intestine with liver; the 6 to month category decreases by 57.9% from 47.1 percent at 1998-1999 to 19.8 percent at 2014-2015; the 1 to year category decreases by 51.3% from 57.5 percent at 1998-1999 to 28 percent at 2014-2015; the 3 to year category decreases by 41.4% from 62.7 percent at 1998-1999 to 36.7 percent at 2012-2013; the 5 to year category decreases by 29.7% from 63.9 percent at 1998-1999 to 44.9 percent at 2010-2011; and the 10 to year category decreases by 22.1% from 67.6 percent at 1998-1999 to 52.7 percent at 2004-2005.

Figure IN 38. Graft failure among transplant recipients of intestine with liver
All recipients of deceased donor intestines, including multi-organ transplants. Patients are followed until the earliest of retransplant, graft failure, death, or December 31, 2016. Estimates computed with Cox proportional hazards models adjusted for age, sex, and race.


A line plot for graft survival among intestine transplant recipients, 2009-2011, by age; the  less than  18 category decreases by 45.9% from 100 percent at 0 Months post-transplant to 54.1 percent at 60 Months post-transplant; the  greater than or equal to 18 category decreases by 55.9% from 100 percent at 0 Months post-transplant to 44.1 percent at 60 Months post-transplant; and the all category decreases by 51.3% from 100 percent at 0 Months post-transplant to 48.7 percent at 60 Months post-transplant.

Figure IN 39. Graft survival among intestine transplant recipients, 2009-2011, by age
Intestine graft survival estimated using unadjusted Kaplan-Meier methods.


A line plot for graft survival among adult deceased donor intestine transplant recipients, 2011, by transplant type; the in category decreases by 52.4% from 100 percent at 0 Months post-transplant to 47.6 percent at 60 Months post-transplant; and the in to li category decreases by 49.4% from 100 percent at 0 Months post-transplant to 50.6 percent at 60 Months post-transplant.

Figure IN 40. Graft survival among adult deceased donor intestine transplant recipients, 2011, by transplant type
Intestine graft survival estimated using unadjusted Kaplan-Meier methods. IN-LI includes intestine-liver transplants with possibly one or more additional organs; 50 recipients of intestine transplants with one or more other organs but not a liver were excluded by IN vs. IN-LI.


A line plot for recipients alive with a functioning intestine graft on june 30 of the year, by age at transplant and procedure; the age  less than  18, in category increases by 66.3% from 98 patients at 2005 to 163 patients at 2016; the age  greater than or equal to  18, in category increases by 166.9% from 124 patients at 2005 to 331 patients at 2016; the age  less than  18, in to li category increases by 125.8% from 217 patients at 2005 to 490 patients at 2016; the age  greater than or equal to  18, in to li category increases by 126.0% from 77 patients at 2005 to 174 patients at 2016; and the all category increases by 124.4% from 516 patients at 2005 to 1158 patients at 2016.

Figure IN 41. Recipients alive with a functioning intestine graft on June 30 of the year, by age at transplant and procedure
Recipients are assumed to be alive with function unless a death or graft failure is recorded. A recipient may experience a graft failure and be removed from the cohort, undergo retransplant, and re-enter the cohort.


A bar plot for incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by age and transplant type, the age  less than  18, in age and transplant type is 46.81 percent for 2010-11, 37.84 percent for 2012 to 13, and 65.71 percent for 2014 to 15; the age  greater than or equal to  18, in age and transplant type is 46.22 percent for 2010-11, 36.84 percent for 2012 to 13, and 36.27 percent for 2014 to 15; the age  less than  18, in to li age and transplant type is 35.82 percent for 2010-11, 45.45 percent for 2012 to 13, and 34.18 percent for 2014 to 15; the age  greater than or equal to  18, in to li age and transplant type is 31.91 percent for 2010-11, 19.15 percent for 2012 to 13, and 29.69 percent for 2014 to 15; and the all age and transplant type is 41.43 percent for 2010-11, 35.35 percent for 2012 to 13, and 37.86 percent for 2014 to 15.

Figure IN 42. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by age and transplant type
Acute rejection is defined as a record of acute or hyperacute rejection, as reported on the OPTN Transplant Recipient Registration or Transplant Recipient Follow-up Form. Only the first rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier competing risk method.


A line plot for incidence of ptld among recipients of intestine transplant without liver by recipient ebv status at transplant, 2004-2014; the ebv to  category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv+ category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv unknown category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; and the all category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant.

Figure IN 43. Incidence of PTLD among recipients of intestine transplant without liver by recipient EBV status at transplant, 2004-2014
Cumulative incidence is estimated using the Kaplan-Meier competing risk method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.


A line plot for incidence of ptld among recipients of intestine transplant with liver by recipient ebv status at transplant, 2004-2014; the ebv to  category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv+ category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv unknown category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; and the all category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant.

Figure IN 44. Incidence of PTLD among recipients of intestine transplant with liver by recipient EBV status at transplant, 2004-2014
Cumulative incidence is estimated using the Kaplan-Meier competing risk method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.


A line plot for patient survival among adult deceased donor intestine transplant recipients, 2009-2011, by age and transplant type; the age  less than  18, in category decreases by 32.3% from 100 percent at 0 Months post-transplant to 67.7 percent at 60 Months post-transplant; the age  greater than or equal to 18, in category decreases by 37.5% from 100 percent at 0 Months post-transplant to 62.5 percent at 60 Months post-transplant; the age  less than  18, in to li category decreases by 37.9% from 100 percent at 0 Months post-transplant to 62.1 percent at 60 Months post-transplant; and the age  greater than or equal to 18, in to li category decreases by 59.7% from 100 percent at 0 Months post-transplant to 40.3 percent at 60 Months post-transplant.

Figure IN 45. Patient survival among adult deceased donor intestine transplant recipients, 2009-2011, by age and transplant type
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


Table IN 1 Demographic characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Candidates waiting for intestines with and without liver on December 31, 2016, regardless of first listing date; multiple listings are collapsed.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Age: < 6 years 116 71.2% 72 67.3%
Age: 6-17 years 17 10.4% 15 14.0%
Age: 18-34 years 15 9.2% 8 7.5%
Age: 35-49 years 12 7.4% 11 10.3%
Age: 50-64 years 3 1.8% 1 0.9%
Sex: Female 82 50.3% 47 43.9%
Sex: Male 81 49.7% 60 56.1%
Race/ethnicity: White 92 56.4% 53 49.5%
Race/ethnicity: Black 36 22.1% 23 21.5%
Race/ethnicity: Hispanic 26 16.0% 22 20.6%
Race/ethnicity: Asian 6 3.7% 4 3.7%
Race/ethnicity: Other/unknown 3 1.8% 5 4.7%
All candidates 163 100.0% 107 100.0%



Table IN 2 Clinical characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Candidates waiting for intestines with and without liver on December 31, 2016, regardless of first listing date; multiple listings are collapsed. SGS, short-gut syndrome. MELD scores are given for intestine-liver candidates.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Diagnosis: Necrotizing enterocolitis 25 15.3% 9 8.4%
Diagnosis: Congenital SGS 36 22.1% 25 23.4%
Diagnosis: Non-congenital SGS 49 30.1% 25 23.4%
Diagnosis: Pseudo-obstruction 19 11.7% 3 2.8%
Diagnosis: Enteropathies 2 1.2% 8 7.5%
Diagnosis: Other/unknown 32 19.6% 37 34.6%
Blood type: A 59 36.2% 35 32.7%
Blood type: B 16 9.8% 18 16.8%
Blood type: AB 8 4.9% 4 3.7%
Blood type: O 80 49.1% 50 46.7%
IN medical urgency: Status 1 53 32.5% 64 59.8%
IN medical urgency: Non-urgent 69 42.3% 16 15.0%
IN medical urgency: Inactive 41 25.2% 27 25.2%
LI medical urgency: Status 1A/1B 1 0.9%
LI medical urgency: MELD/PELD ≥ 35 18 16.8%
LI medical urgency: MELD/PELD 30-34 9 8.4%
LI medical urgency: MELD/PELD 15-29 50 46.7%
LI medical urgency: MELD/PELD < 15 0 0.0%
LI medical urgency: Unknown 0 0.0%
LI medical urgency: Inactive 29 27.1%
All candidates 163 100.0% 107 100.0%



Table IN 3 Listing characteristics of candidates on the intestine transplant waiting list on December 31, 2016
Candidates waiting for intestines with and without liver on December 31, 2016, regardless of first listing date; multiple listings are collapsed.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Transplant history: First 157 96.3% 90 84.1%
Transplant history: Retransplant 6 3.7% 17 15.9%
Wait time: < 1 year 50 30.7% 44 41.1%
Wait time: 1-< 2 years 24 14.7% 19 17.8%
Wait time: 2-< 3 years 21 12.9% 11 10.3%
Wait time: 3-< 4 years 15 9.2% 4 3.7%
Wait time: 4-< 5 years 14 8.6% 3 2.8%
Wait time: ≥ 5 years 39 23.9% 26 24.3%
Tx type: Intestine only 144 88.3% 0 0.0%
Tx type: Intestine-liver 0 0.0% 2 1.9%
Tx type: Intestine-pancreas 14 8.6% 0 0.0%
Tx type: Intestine-pancreas-liver 0 0.0% 101 94.4%
Tx type: Intestine-pancreas-liver-kidney 0 0.0% 4 3.7%
Tx type: Other 5 3.1% 0 0.0%
All candidates 163 100.0% 107 100.0%



Table IN 4 Intestine transplant waitlist activity, 2016
Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. Candidates who are listed, undergo transplant, and are relisted are counted more than once. Candidates are not considered to be on the list on the day they are removed. Candidates listed for multi-organ transplants are included.
Waiting list state IN IN-LI
Patients at start of year 155 104
Patients added during year 98 97
Patients removed during year 90 94
Patients at end of year 163 107



Table IN 5 Removal reason among intestine transplant candidates, 2016
Removal reason as reported to the OPTN. Candidates with death dates that precede removal dates are assumed to have died waiting.
Removal reason IN IN-LI
Deceased donor transplant 77 70
Living donor transplant 0 0
Patient died 4 9
Patient refused transplant 0 0
Improved, transplant not needed 3 5
Too sick for transplant 1 6
Other 5 4



Table IN 6 Demographic characteristics of intestine transplant recipients, 2016
Intestine transplant recipients, including retransplants.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Age: < 18 years 22 27.5% 35 52.2%
Age: 18-34 years 16 20.0% 12 17.9%
Age: 35-49 years 22 27.5% 9 13.4%
Age: 50-64 years 20 25.0% 11 16.4%
Sex: Female 37 46.2% 21 31.3%
Sex: Male 43 53.8% 46 68.7%
Race/ethnicity: White 55 68.8% 41 61.2%
Race/ethnicity: Black 12 15.0% 12 17.9%
Race/ethnicity: Hispanic 12 15.0% 10 14.9%
Race/ethnicity: Asian 1 1.2% 3 4.5%
Race/ethnicity: Other/unknown 0 0.0% 1 1.5%
Insurance: Private 29 36.2% 20 29.9%
Insurance: Medicaid 23 28.8% 32 47.8%
Insurance: Unknown 28 35.0% 15 22.4%
All recipients 80 100.0% 67 100.0%



Table IN 7 Clinical characteristics of intestine transplant recipients, 2016
Intestine transplant recipients, including retransplants. SGS, short-gut syndrome.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Diagnosis: Necrotizing enterocolitis 1 1.2% 6 9.0%
Diagnosis: Congenital SGS 11 13.8% 12 17.9%
Diagnosis: Non-congenital SGS 47 58.8% 32 47.8%
Diagnosis: Pseudo-obstruction 7 8.8% 0 0.0%
Diagnosis: Enteropathies 1 1.2% 1 1.5%
Diagnosis: Other/unknown 13 16.2% 16 23.9%
Blood type: A 28 35.0% 27 40.3%
Blood type: B 10 12.5% 3 4.5%
Blood type: AB 0 0.0% 6 9.0%
Blood type: O 42 52.5% 31 46.3%
Medical condition: Hospitalized in ICU 0 0.0% 6 9.0%
Medical condition: Hospitalized, not ICU 9 11.2% 19 28.4%
Medical condition: Not hospitalized 70 87.5% 42 62.7%
Medical condition: Hospitalization unknown 1 1.2% 0 0.0%
IN medical urgency: Status 1 63 78.8% 46 68.7%
IN medical urgency: Non-urgent 17 21.2% 21 31.3%
LI medical urgency: Status 1A/1B 7 10.4%
LI medical urgency: MELD/PELD ≥ 35 12 17.9%
LI medical urgency: MELD/PELD 30-34 6 9.0%
LI medical urgency: MELD/PELD 15-29 30 44.8%
LI medical urgency: MELD/PELD < 15 11 16.4%
LI medical urgency: Unknown 1 1.5%
All recipients 80 100.0% 67 100.0%



Table IN 8 Transplant characteristics of intestine transplant recipients, 2016
Intestine transplant recipients, including retransplants.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Wait time: < 31 days 16 20.0% 12 17.9%
Wait time: 31-60 days 14 17.5% 10 14.9%
Wait time: 61-90 days 12 15.0% 9 13.4%
Wait time: 3-< 6 months 15 18.8% 20 29.9%
Wait time: 6-< 12 months 8 10.0% 8 11.9%
Wait time: 1-< 2 years 11 13.8% 4 6.0%
Wait time: ≥ 2 years 4 5.0% 4 6.0%
Donor type: Deceased 80 100.0% 67 100.0%
Transplant history: First 74 92.5% 53 79.1%
Transplant history: Retransplant 6 7.5% 14 20.9%
Tx type: Intestine only 67 83.8% 0 0.0%
Tx type: Intestine-liver-pancreas 0 0.0% 58 86.6%
Tx type: Intestine-liver 0 0.0% 2 3.0%
Tx type: Other 13 16.2% 7 10.4%
All recipients 80 100.0% 67 100.0%