Skip To Main Content
Intestine

OPTN/SRTR 2018 Annual Data Report: Intestine

Abstract

Despite medical and surgical advances in treatment of intestinal failure, intestine transplant still plays an important role. However, the number of new patients added to the intestine transplant waiting list has decreased over the past decade, reaching a low of 135 in 2018. The number of intestine donors also decreased, reaching a low of 106 in 2018, and the number of intestine transplants performed declined to its lowest level, 104, of which 59% were intestine-liver transplants. Graft failure has plateaued over the past decade. Patient survival for transplants in 2011-2013 varied by age and transplant type. Patient survival was lowest for adult intestine-liver recipients (1- and 5-year survival 66.7% and 49.1%, respectively) and highest for pediatric intestine recipients (1- and 5-year survival 89.1% and 76.4%, respectively).

Introduction

Medical and surgical advances in treatments of intestinal failure led to a decrease in the number of intestine transplants from 2007 to 2012. However, since then, numbers appear to be relatively stable. Patient survival has improved, and morbidity associated with parenteral nutrition, particularly 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, referred to as intestine-liver and intestine transplants, respectively.

Waiting List

The number of new patients added to the intestine transplant waiting list has decreased over the past decade, reaching a low of 135 in 2018 compared with 273 in 2007; 62 new patients were added for intestine and 73 for intestine-liver transplant (Figure IN 1). Among the 244 prevalent patients on the waiting list at the end of 2018, 147 (60.3%) were waiting for intestine and 97 (39.8%) for intestine-liver transplant (Figure IN 2). 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 2018, 54.1% of candidates on the intestine waiting list were aged younger than 18 years, with a shift toward fewer aged younger than 6 years and more aged 6-17 years than in previous years. Adults accounted for 45.9% of candidates on the list (Figure IN 3). The racial/ethnic distribution remained relatively consistent over time; white patients represented almost 60% of those waiting for an intestine transplant in 2018 (Figure IN 5). The most common etiology of intestinal failure remained short-gut syndrome (SGS; 46.2%), which encompasses a large group of diagnoses (Figure IN 6).

Characteristics of intestine and intestine-liver candidates on the waiting list at the end of 2018 were similar with respect to age and race (Table IN 1). Intestine candidates were 57.8% female and intestine-liver candidates 39.2%. Considering disease etiology, congenital and non-congenital SGS were the leading causes of disease among intestine and intestine-liver transplant candidates (Table IN 2). Intestine-liver candidates were more often listed as status 1 than intestine candidates (51.5% vs. 33.3%; Table IN 2), and they were more often listed for retransplant (Table IN 3). Transplant rates varied by candidate age and transplant type (intestine, intestine-liver) but decreased for all groups over the past decade (Figure IN 10). In 2018, transplant rates were higher for intestine-liver candidates than for intestine candidates. Rates were 79.2 per 100 waitlist-years for pediatric intestine-liver candidates and 64.2 per 100 waitlist-years for adult intestine-liver candidates, and 51.4 for pediatric intestine candidates and 5.4 for adult intestine candidates (Figure IN 10).

Of the 63 candidates removed from the intestine waiting list in 2018, 42 (66.7%) underwent deceased donor transplant, four (6.3%) died, five (7.9%) were removed from the list because their condition improved, and three (4.8%) were considered too sick to undergo transplant (Table IN 4, Table IN 5). Of the 85 candidates removed from the intestine-liver waiting list, 62 (73.0%) underwent deceased donor transplant, ten (11.8%) died, seven (8.2%) were removed from the list because their condition improved, and four (4.7%) were considered too sick to undergo transplant (Table IN 4, Table IN 5). Regarding 3-year outcomes, 70.3% of intestine transplant candidates listed in 2015 underwent deceased donor transplant, 2.2% died, 9.9% were removed from the list, and 17.6% were still waiting in 2018 (Figure IN 11). Of intestine-liver candidates listed in 2015, 61.0% underwent deceased donor transplant, 11.4% died, 18.1% were removed from the list, and 9.5% were still waiting in 2018 (Figure IN 12). Among candidates listed in 2017-2018, median time to transplant was 6.0 months for intestine-liver transplant candidates, and 10.6 months for intestine transplant candidates (Figure IN 13).

Among candidates on the waiting list in 2017-2018, by age, pretransplant mortality was higher for adults, at 10.5 per 100 waitlist-years, and lower for pediatric patients, at 3.8 per 100 waitlist-years (Figure IN 14). Pretransplant mortality was similar for the different etiologies of organ failure (Figure IN 16). Regarding age and type of transplant, pretransplant mortality was highest for pediatric intestine-liver and lowest for adult intestine candidates (respectively, 16.5 vs. 1.8 deaths per 100 waitlist-years in 2017-2018) (Figure IN 17).

Donation

The number of intestine donors decreased over the past decade, reaching a low of 106 in 2018 (Figure IN 18). The proportion of intestine donors in 2018 aged younger than 18 years was 61.3% (Figure IN 19). Most intestine donors were white (57.6%) (Figure IN 21). The overall rate of intestines recovered for transplant and not transplanted was 3.6% in 2017-2018 (Figure IN 23). The most common cause of death among deceased intestine donors has been head trauma, 49.1% in 2018 (Figure IN 26).

Transplant

In 2018, the number of intestine transplants performed declined to its lowest level, 104, of which 59% were intestine-liver transplants (Figure IN 27). In 2018, 18 programs were performing intestine transplants, three only in children, eight only in adults, and seven in both adults and children (Figure IN 35). The median annual program volume was three intestine transplants in 2018; the 95th percentile of program volume was 20 transplants (Figure IN 36). In 2018, 47.1% of intestine transplants were performed at programs performing ten or more transplants per year, 43.3% at programs performing three to nine transplants per year, and only 9.6% at programs performing one to two transplant per year (Figure IN 37). New program requirements were introduced in 2018, but their effects cannot yet be determined.

The age distribution of intestine and intestine-liver transplant recipients changed over the past decade; pediatric recipient counts declined from 94 in 2009 to 37 in 2018, and adult recipient counts declined more modestly from 85 to 67 (Figure IN 28). In 2018, just over half of intestine-liver recipients were aged younger than 18 years, 52.5% vs. 11.6% 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). Within 1 year of listing, 81.4% of intestine candidates and 77.0% of intestine-liver candidates underwent transplant (Table IN 8).

Immunosuppression

In 2018, T-cell depleting agents were used as induction in 63.9% of intestine transplant recipients, with and without a liver; 27.8% of recipients received no induction and 10.3% used IL-2 receptor antagonist therapy (Figure IN 32). The most common initial immunosuppression agent regimens in 2018 were tacrolimus and steroids (42.9%), followed by tacrolimus, mycophenolate, and steroids (28.6%)(Figure IN 33).

Outcomes

Graft failure has plateaued over the past decade. The unadjusted graft failure rate among intestine transplant recipients was 14.4% at 6 months and 22% at 1 year for transplants in 2016-2017, 38.7% at 3 years for transplants in 2014-2015, 54.9% at 5 years for transplants in 2012-2013, and 63.8% at 10 years for transplants in 2008-2009 (Figure IN 38). Among intestine-liver transplant recipients, the graft failure rate was 25% at 6 months and 28.2% at 1 year for transplants in 2016-2017, 42.7% at 3 years for transplants in 2014-2015, 42.1% at 5 years for transplants in 2012-2013, and 57.6% at 10 years for transplants in 2008-2009 (Figure IN 39). For intestine transplants with or without a liver in 2011-2013, 1- and 5-year graft survival was 74.2% and 51.1%, respectively, 72.8% and 46.9% for recipients aged 18 years or older, and 76.2% and 56.8% for recipients aged younger than 18 (Figure IN 40). One- and 5-year graft survival was 76.2% and 47.0%, respectively, for intestine recipients, and 72.9% and 55.8%, respectively, for intestine-liver recipients (Figure IN 41). The number of recipients alive with a functioning intestine graft continued to increase, to 1204, on June 30, 2018; pediatric intestine-liver transplant recipients were the predominant group at 43% (Figure IN 44). The incidence of first acute rejection in the first year posttransplant varied by age group and transplant type. Among recipients in 2016-2017, incidence of acute rejection was highest in pediatric intestine recipients (58.5%) and lowest in adult intestine-liver recipients (24.6%) (Figure IN 45). For recipients in 2006-2016, 8.9% of intestine recipients (Figure IN 47) and 7.4% of intestine-liver recipients (Figure IN 48) developed posttransplant lymphoproliferative disorder within 5 years posttransplant. Patient survival for transplants in 2011-2013 varied by age and transplant type. Patient survival was lowest for adult intestine-liver recipients (1- and 5-year survival 66.7% and 49.1%, respectively) and highest for pediatric intestine recipients (1- and 5-year survival 89.1% and 76.4%, respectively) (Figure IN 49).

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 sex
Figure IN 5. Distribution of candidates waiting for intestine transplant by race
Figure IN 6. Distribution of candidates waiting for intestine transplant by diagnosis
Figure IN 7. Distribution of candidates waiting for intestine transplant by waiting time
Figure IN 8. Distribution of candidates waiting for intestine transplant by medical urgency
Figure IN 9. Distribution of candidates waiting for intestine transplant by liver co-listing
Figure IN 10. Deceased donor intestine transplant rates among waitlist candidates by age and liver co-listing
Figure IN 11. Three-year outcomes for candidates waiting for intestine transplant without liver, new listings in 2015
Figure IN 12. Three-year outcomes for candidates waiting for intestine transplant with liver, new listings in 2015
Figure IN 13. Median months to intestine transplant for waitlist candidates by liver co-listing
Figure IN 14. Pretransplant mortality rates among candidates waitlisted for intestine transplant by age
Figure IN 15. Pretransplant mortality rates among candidates waitlisted for intestine transplant by race
Figure IN 16. Pretransplant mortality rates among candidates waitlisted for intestine transplant by diagnosis
Figure IN 17. Pretransplant mortality rates among candidates waitlisted for intestine transplant by age and liver co-listing

Deceased donation

Figure IN 18. Deceased intestine donor count by age
Figure IN 19. Distribution of deceased intestine donors by age
Figure IN 20. Distribution of deceased intestine donors by sex
Figure IN 21. Distribution of deceased intestine donors by race
Figure IN 22. Rates of intestines recovered for transplant and not transplanted by donor age
Figure IN 23. Rates of intestines recovered for transplant and not transplanted by donor sex
Figure IN 24. Rates of intestines recovered for transplant and not transplanted by donor race
Figure IN 25. Rates of intestines recovered for transplant and not transplanted, by donor risk of disease transmission
Figure IN 26. Cause of death among deceased intestine donors

Transplant

Figure IN 27. Total intestine transplants
Figure IN 28. Total intestine transplants by age
Figure IN 29. Total intestine transplants by sex
Figure IN 30. Total intestine transplants by race
Figure IN 31. Total intestine transplants by diagnosis
Figure IN 32. Induction agent use in intestine transplant recipients
Figure IN 33. Immunosuppression regimen use in intestine transplant recipients
Figure IN 34. Total HLA A, B, and DR mismatches among deceased donor intestine transplant recipients, 2014-2018
Figure IN 35. Number of centers performing adult and pediatric intestine transplants by center's age mix
Figure IN 36. Annual intestine transplant center volumes, by percentile
Figure IN 37. Distribution of intestine transplants by annual center volume

Outcomes

Figure IN 38. Graft failure among transplant recipients of intestine without liver
Figure IN 39. Graft failure among transplant recipients of intestine with liver
Figure IN 40. Graft survival among intestine transplant recipients, 2011-2013, by age
Figure IN 41. Graft survival among deceased donor intestine transplant recipients, 2011-2013, by transplant type
Figure IN 42. Graft survival among deceased donor intestine transplant recipients, 2011-2013, by metropolitan vs. non-metropolitan recipient residence
Figure IN 43. Graft survival among deceased donor intestine transplant recipients, 2011-2013, by recipients' distance from transplant center
Figure IN 44. Recipients alive with a functioning intestine graft on June 30 of the year, by age at transplant and procedure
Figure IN 45. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by age and transplant type, 2016-2017
Figure IN 46. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by induction agent 2016-2017
Figure IN 47. Incidence of PTLD among recipients of intestine transplant without liver by recipient EBV status at transplant, 2006-2016
Figure IN 48. Incidence of PTLD among recipients of intestine transplant with liver by recipient EBV status at transplant, 2006-2016
Figure IN 49. Patient survival among deceased donor intestine transplant recipients, 2011-2013, 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, 2018
Table IN 2. Clinical characteristics of candidates on the intestine transplant waiting list on December 31, 2018
Table IN 3. Listing characteristics of candidates on the intestine transplant waiting list on December 31, 2018
Table IN 4. Intestine transplant waitlist activity, 2018
Table IN 5. Removal reason among intestine transplant candidates, 2018

Transplant

Table IN 6. Demographic characteristics of intestine transplant recipients, 2018
Table IN 7. Clinical characteristics of intestine transplant recipients, 2018
Table IN 8. Transplant characteristics of intestine transplant recipients, 2018

A line plot for new candidates added to the intestine transplant waiting list; the in category decreases by 31.9% from 91 candidates at 2007 to 62 candidates at 2018; the in to li category decreases by 59.9% from 182 candidates at 2007 to 73 candidates at 2018; and the all category decreases by 50.5% from 273 candidates at 2007 to 135 candidates at 2018.

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 47.0% from 100 candidates at 2007 to 147 candidates at 2018; the in to li category decreases by 16.4% from 116 candidates at 2007 to 97 candidates at 2018; and the all category increases by 13.0% from 216 candidates at 2007 to 244 candidates at 2018.

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 50.3% from 53.4 percent at 2007 to 26.5 percent at 2018; the 6 to 17 category increases by 97.6% from 13.9 percent at 2007 to 27.6 percent at 2018; the 18 to 34 category increases by 84.7% from 10.4 percent at 2007 to 19.1 percent at 2018; and the greater than or equal to 35 category increases by 20.1% from 22.3 percent at 2007 to 26.8 percent at 2018.

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 sex; the male category is 57.2 percent at 2007 and remains relatively constant with a value of 51.8 percent at 2018; and the female category increases by 12.6% from 42.8 percent at 2007 to 48.2 percent at 2018.

Figure IN 4. Distribution of candidates waiting for intestine transplant by sex
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.


A line plot for distribution of candidates waiting for intestine transplant by race; the white category is 65.1 percent at 2007 and remains relatively constant with a value of 59.2 percent at 2018; the black category increases by 15.1% from 17.7 percent at 2007 to 20.4 percent at 2018; the hispanic category is 13.7 percent at 2007 and remains relatively constant with a value of 14.8 percent at 2018; the asian category increases by 49.4% from 2.4 percent at 2007 to 3.6 percent at 2018; and the other/unknown category increases by 104.9% from 1 percent at 2007 to 2 percent at 2018.

Figure IN 5. 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 28.0% from 12.7 percent at 2007 to 9.2 percent at 2018; the congenital sgs category is 21.1 percent at 2007 and remains relatively constant with a value of 19.6 percent at 2018; the non to congenital sgs category decreases by 12.4% from 30.3 percent at 2007 to 26.5 percent at 2018; the pseudo to obstruction category increases by 164.7% from 3 percent at 2007 to 7.9 percent at 2018; the enteropathies category decreases by 14.6% from 3 percent at 2007 to 2.6 percent at 2018; and the other/unknown category increases by 14.4% from 29.9 percent at 2007 to 34.2 percent at 2018.

Figure IN 6. 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 36.5% from 67.5 percent at 2007 to 42.9 percent at 2018; the 1 to less than 2 category is 14.9 percent at 2007 and remains relatively constant with a value of 15.6 percent at 2018; the 2 to less than 3 category increases by 43.6% from 6.6 percent at 2007 to 9.4 percent at 2018; the 3 to less than 4 category increases by 79.3% from 4 percent at 2007 to 7.1 percent at 2018; the 4 to less than 5 category increases by 227.3% from 1.8 percent at 2007 to 5.9 percent at 2018; and the greater than or equal to 5 category increases by 269.4% from 5.2 percent at 2007 to 19.1 percent at 2018.

Figure IN 7. 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 23.6% from 74.5 percent at 2007 to 56.9 percent at 2018; the non to urgent category increases by 72.2% from 17.9 percent at 2007 to 30.9 percent at 2018; and the inactive category increases by 61.8% from 7.6 percent at 2007 to 12.2 percent at 2018.

Figure IN 8. 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 42.4% from 37.3 percent at 2007 to 53.1 percent at 2018; and the in to li category decreases by 25.2% from 62.7 percent at 2007 to 46.9 percent at 2018.

Figure IN 9. 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 waitlist candidates by age and liver co-listing; the in to li, age less than 18 category decreases by 47.8% from 98.5 transplants per 100 waitlist years at 2007 to 51.4 transplants per 100 waitlist years at 2018; the in, age less than 18 category decreases by 81.3% from 28.9 transplants per 100 waitlist years at 2007 to 5.4 transplants per 100 waitlist years at 2018; the in to li, age greater than or equal to 18 category decreases by 60.1% from 198.5 transplants per 100 waitlist years at 2007 to 79.2 transplants per 100 waitlist years at 2018; and the in, age greater than or equal to 18 category decreases by 47.4% from 122 transplants per 100 waitlist years at 2007 to 64.2 transplants per 100 waitlist years at 2018.

Figure IN 10. Deceased donor intestine transplant rates among waitlist candidates by age and liver co-listing
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Intestine-liver co-listing is determined at the time of listing. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for three-year outcomes for candidates waiting for intestine transplant without liver, new listings in 2015; the still waiting category decreases by 82.4% from 100 percent at 0 Months postlisting to 17.6 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 without liver, new listings in 2015
Candidates waiting for intestine transplant and first listed in 2015. 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 2015; the still waiting category decreases by 90.4% from 99 percent at 0 Months postlisting to 9.5 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 increases by 1100.0% from 1 percent at 0 Months postlisting to 11.4 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 12. Three-year outcomes for candidates waiting for intestine transplant with liver, new listings in 2015
Candidates waiting for intestine-liver transplant and first listed in 2015. 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 liver co-listing; the in category increases by 119.7% from 4.8 months at 2007-2008 to 10.6 months at 2017-2018; the in to li category increases by 15.7% from 5.2 months at 2007-2008 to 6 months at 2017-2018; and the all category increases by 54.6% from 5 months at 2007-2008 to 7.7 months at 2017-2018.

Figure IN 13. Median months to intestine transplant for waitlist candidates by liver co-listing
Observations censored on December 31, 2018; 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 18 category decreases by 78.2% from 17.5 deaths per 100 waitlist years at 2007-2008 to 3.8 deaths per 100 waitlist years at 2017-2018; the greater than or equal to 18 category decreases by 65.6% from 30.5 deaths per 100 waitlist years at 2007-2008 to 10.5 deaths per 100 waitlist years at 2017-2018; and the all category decreases by 70.4% from 20.8 deaths per 100 waitlist years at 2007-2008 to 6.2 deaths per 100 waitlist years at 2017-2018.

Figure IN 14. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 60.0% from 20 deaths per 100 waitlist years at 2007-2008 to 8 deaths per 100 waitlist years at 2017-2018; the black category decreases by 83.3% from 19.4 deaths per 100 waitlist years at 2007-2008 to 3.2 deaths per 100 waitlist years at 2017-2018; and the hispanic category decreases by 79.1% from 24.5 deaths per 100 waitlist years at 2007-2008 to 5.1 deaths per 100 waitlist years at 2017-2018.

Figure IN 15. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by diagnosis; the necrotizing enterocolitis category decreases by 78.5% from 30.9 deaths per 100 waitlist years at 2007-2008 to 6.6 deaths per 100 waitlist years at 2017-2018; the congenital sgs category decreases by 87.7% from 26.2 deaths per 100 waitlist years at 2007-2008 to 3.2 deaths per 100 waitlist years at 2017-2018; the non to congential sgs category decreases by 64.9% from 20.4 deaths per 100 waitlist years at 2007-2008 to 7.2 deaths per 100 waitlist years at 2017-2018; and the other/unknown category decreases by 54.9% from 15.5 deaths per 100 waitlist years at 2007-2008 to 7 deaths per 100 waitlist years at 2017-2018.

Figure IN 16. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. SGS, short-gut syndrome.


A line plot for pretransplant mortality rates among candidates waitlisted for intestine transplant by age and liver co-listing; the in to li, age less than 18 category decreases by 76.3% from 28.8 deaths per 100 waitlist years at 2007-2008 to 6.8 deaths per 100 waitlist years at 2017-2018; the in, age less than 18 category decreases by 63.4% from 5 deaths per 100 waitlist years at 2007-2008 to 1.8 deaths per 100 waitlist years at 2017-2018; the in to li, age greater than or equal to 18 category decreases by 65.4% from 47.7 deaths per 100 waitlist years at 2007-2008 to 16.5 deaths per 100 waitlist years at 2017-2018; and the in, age greater than or equal to 18 category decreases by 64.0% from 18.3 deaths per 100 waitlist years at 2007-2008 to 6.6 deaths per 100 waitlist years at 2017-2018.

Figure IN 17. Pretransplant mortality rates among candidates waitlisted for intestine transplant by age and liver co-listing
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. Intestine-liver co-listing is determined at the later of listing date and January 1 of the year.


A line plot for deceased intestine donor count by age; the all category decreases by 46.2% from 197 count at 2007 to 106 count at 2018; the less than 18 category decreases by 53.6% from 140 count at 2007 to 65 count at 2018; and the greater than or equal to 18 category decreases by 28.1% from 57 count at 2007 to 41 count at 2018.

Figure IN 18. Deceased intestine donor count by age
Count of deceased donors whose intestines were recovered for transplant, by age at donation.


A line plot for distribution of deceased intestine donors by age; the less than 18 category decreases by 13.7% from 71.1 percent at 2007 to 61.3 percent at 2018; and the greater than or equal to 18 category increases by 33.7% from 28.9 percent at 2007 to 38.7 percent at 2018.

Figure IN 19. Distribution of deceased intestine donors by age
Deceased donors whose intestines were recovered for transplant.


A line plot for distribution of deceased intestine donors by sex; the male category is 68 percent at 2007 and remains relatively constant with a value of 68.9 percent at 2018; and the female category is 32 percent at 2007 and remains relatively constant with a value of 31.1 percent at 2018.

Figure IN 20. Distribution of deceased intestine donors by sex
Deceased donors whose intestines were recovered for transplant.


A line plot for distribution of deceased intestine donors by race; the white category is 58.9 percent at 2007 and remains relatively constant with a value of 57.5 percent at 2018; the black category is 23.4 percent at 2007 and remains relatively constant with a value of 22.6 percent at 2018; the hispanic category is 14.7 percent at 2007 and remains relatively constant with a value of 14.2 percent at 2018; and the other/unknown category increases by 85.8% from 3 percent at 2007 to 5.7 percent at 2018.

Figure IN 21. Distribution of 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 donor age; the less than 18 category decreases by 47.6% from 4.3 percent at 2007-2008 to 2.3 percent at 2017-2018; and the greater than or equal to 18 category decreases by 22.6% from 7.3 percent at 2007-2008 to 5.6 percent at 2017-2018.

Figure IN 22. Rates of intestines recovered for transplant and not transplanted by donor 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 donor sex; the male category is 4 percent at 2007-2008 and remains relatively constant with a value of 3.6 percent at 2017-2018; the female category decreases by 51.3% from 7.3 percent at 2007-2008 to 3.6 percent at 2017-2018; and the all category decreases by 30.8% from 5.2 percent at 2007-2008 to 3.6 percent at 2017-2018.

Figure IN 23. Rates of intestines recovered for transplant and not transplanted by donor 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 donor race; the white category decreases by 38.3% from 5.8 percent at 2007-2008 to 3.6 percent at 2017-2018; the black category is 2.4 percent at 2007-2008 and remains relatively constant with a value of 2.2 percent at 2017-2018; and the other/unknown category decreases by 13.5% from 6.2 percent at 2007-2008 to 5.4 percent at 2017-2018.

Figure IN 24. Rates of intestines recovered for transplant and not transplanted by donor race
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 donor risk of disease transmission; the phs increased risk category decreases by 57.1% from 16.7 percent at 2007-2008 to 7.1 percent at 2017-2018; and the not increased risk category decreases by 40.6% from 4.7 percent at 2007-2008 to 2.8 percent at 2017-2018.

Figure IN 25. Rates of intestines recovered for transplant and not transplanted, by donor risk of disease transmission
"Increased risk" is defined by criteria from the US Public Health Service Guidelines for increased risk for HIV, hepatitis B and hepatitis C transmission.


A line plot for cause of death among deceased intestine donors; the anoxia category increases by 45.4% from 23.4 percent at 2007 to 34 percent at 2018; the cva/stroke category increases by 18.9% from 12.7 percent at 2007 to 15.1 percent at 2018; the head trauma category decreases by 12.1% from 55.8 percent at 2007 to 49.1 percent at 2018; the cns tumor category decreases by 100.0% from 1 percent at 2007 to 0 percent at 2018; and the other category decreases by 73.5% from 7.1 percent at 2007 to 1.9 percent at 2018.

Figure IN 26. 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 decreases by 31.7% from 63 transplants at 2007 to 43 transplants at 2018; the in to li category decreases by 54.8% from 135 transplants at 2007 to 61 transplants at 2018; and the all category decreases by 47.5% from 198 transplants at 2007 to 104 transplants at 2018.

Figure IN 27. 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 66.7% from 111 transplants at 2007 to 37 transplants at 2018; and the greater than or equal to 18 category decreases by 23.0% from 87 transplants at 2007 to 67 transplants at 2018.

Figure IN 28. 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 decreases by 44.4% from 108 transplants at 2007 to 60 transplants at 2018; and the female category decreases by 51.1% from 90 transplants at 2007 to 44 transplants at 2018.

Figure IN 29. 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 53.3% from 137 transplants at 2007 to 64 transplants at 2018; the black category decreases by 20.7% from 29 transplants at 2007 to 23 transplants at 2018; and the other/unknown category decreases by 46.9% from 32 transplants at 2007 to 17 transplants at 2018.

Figure IN 30. 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 42.9% from 21 transplants at 2007 to 12 transplants at 2018; the congenital sgs category decreases by 71.1% from 45 transplants at 2007 to 13 transplants at 2018; the non to congenital sgs category decreases by 50.0% from 76 transplants at 2007 to 38 transplants at 2018; the pseudo to obstruction category decreases by 20.0% from 10 transplants at 2007 to 8 transplants at 2018; the enteropathies category decreases by 50.0% from 6 transplants at 2007 to 3 transplants at 2018; and the other/unknown category decreases by 25.0% from 40 transplants at 2007 to 30 transplants at 2018.

Figure IN 31. 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 10.1 percent at 2007 and remains relatively constant with a value of 10.3 percent at 2018; the t to cell depleting category increases by 58.1% from 40.4 percent at 2007 to 63.9 percent at 2018; and the none category decreases by 47.7% from 53.2 percent at 2007 to 27.8 percent at 2018.

Figure IN 32. Induction agent use in intestine transplant recipients
Immunosuppression at transplant reported to the OPTN. IL2-RA, interleukin-2 receptor antagonist.


A line plot for immunosuppression regimen use in intestine transplant recipients; the tac mmf steroid category increases by 297.1% from 7.2 percent at 2007 to 28.6 percent at 2018; the tac mmf category decreases by 29.1% from 10.1 percent at 2007 to 7.1 percent at 2018; the tac steroid category decreases by 24.6% from 56.8 percent at 2007 to 42.9 percent at 2018; the other category decreases by 17.3% from 25.9 percent at 2007 to 21.4 percent at 2018; and the none reported category is 0 percent at 2007 and is percent at 2018.

Figure IN 33. Immunosuppression regimen use in intestine transplant recipients
Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, mycophenolate mofetil.


A bar plot for total hla a, b, and dr mismatches among deceased donor intestine transplant recipients, 2014-2018, the 0 group is 0.16 percent; the 1 group is 0.47 percent; the 2 group is 2.83 percent; the 3 group is 11.95 percent; the 4 group is 23.74 percent; the 5 group is 38.68 percent; the 6 group is 19.03 percent; and the unk. group is 3.14 percent.

Figure IN 34. Total HLA A, B, and DR mismatches among deceased donor intestine transplant recipients, 2014-2018
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2018.


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

Figure IN 35. Number of centers performing adult and pediatric 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. Pediatric centers transplanted recipients aged 0-17 years, and a small number of adults up to age 21 years.


A line plot for annual intestine transplant center volumes, by percentile; the 5th category is 1 transplants per center at 2007 and remains relatively constant with a value of 1 transplants per center at 2018; the 25th category increases by 100.0% from 1 transplants per center at 2007 to 2 transplants per center at 2018; the median category is 3 transplants per center at 2007 and remains relatively constant with a value of 3 transplants per center at 2018; the 75th category decreases by 52.6% from 19 transplants per center at 2007 to 9 transplants per center at 2018; and the 95th category decreases by 39.4% from 33 transplants per center at 2007 to 20 transplants per center at 2018.

Figure IN 36. Annual intestine transplant center volumes, by percentile
Annual volume data include transplant recipients of any age.


A line plot for distribution of intestine transplants by annual center volume; the 1 to 2 category increases by 58.7% from 6.1 percent of transplants at 2007 to 9.6 percent of transplants at 2018; the 3 to 9 category increases by 152.0% from 17.2 percent of transplants at 2007 to 43.3 percent of transplants at 2018; and the greater than 10 category decreases by 38.6% from 76.8 percent of transplants at 2007 to 47.1 percent of transplants at 2018.

Figure IN 37. Distribution of intestine transplants by annual center volume
Based on annual volume data among recipients of any age.


A line plot for graft failure among transplant recipients of intestine without liver; the 6 to month category decreases by 23.2% from 18.8 percent at 2000-2001 to 14.4 percent at 2016-2017; the 1 to year category decreases by 24.7% from 29.2 percent at 2000-2001 to 22 percent at 2016-2017; the 3 to year category decreases by 25.7% from 52.1 percent at 2000-2001 to 38.7 percent at 2014-2015; the 5 to year category is 60.4 percent at 2000-2001 and remains relatively constant with a value of 54.9 percent at 2012-2013; and the 10 to year category decreases by 12.5% from 72.9 percent at 2000-2001 to 63.8 percent at 2008-2009.

Figure IN 38. 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, 2018.


A line plot for graft failure among transplant recipients of intestine with liver; the 6 to month category decreases by 29.3% from 35.4 percent at 2000-2001 to 25 percent at 2016-2017; the 1 to year category decreases by 38.8% from 46.2 percent at 2000-2001 to 28.2 percent at 2016-2017; the 3 to year category decreases by 20.8% from 53.8 percent at 2000-2001 to 42.7 percent at 2014-2015; the 5 to year category decreases by 25.9% from 56.9 percent at 2000-2001 to 42.2 percent at 2012-2013; and the 10 to year category is 63.1 percent at 2000-2001 and remains relatively constant with a value of 57.6 percent at 2008-2009.

Figure IN 39. 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, 2018.


A line plot for graft survival among intestine transplant recipients, 2011-2013, by age; the less than 18 category decreases by 43.2% from 100 percent at 0 Months post-transplant to 56.8 percent at 60 Months post-transplant; the greater than or equal to 18 category decreases by 53.1% from 100 percent at 0 Months post-transplant to 46.9 percent at 60 Months post-transplant; and the all category decreases by 48.9% from 100 percent at 0 Months post-transplant to 51.1 percent at 60 Months post-transplant.

Figure IN 40. Graft survival among intestine transplant recipients, 2011-2013, by age
Intestine graft survival estimated using unadjusted Kaplan-Meier methods.


A line plot for graft survival among deceased donor intestine transplant recipients, 2011-2013, by transplant type; the in category decreases by 53.0% from 100 percent at 0 Months post-transplant to 47 percent at 60 Months post-transplant; and the in to li category decreases by 44.2% from 100 percent at 0 Months post-transplant to 55.8 percent at 60 Months post-transplant.

Figure IN 41. Graft survival among deceased donor intestine transplant recipients, 2011-2013, 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; 42 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 graft survival among deceased donor intestine transplant recipients, 2011-2013, by metropolitan vs. non-metropolitan recipient residence; the metropolitan category decreases by 50.0% from 100 percent at 0 Months post-transplant to 50 percent at 60 Months post-transplant; and the non to metropolitan category decreases by 43.9% from 100 percent at 0 Months post-transplant to 56.1 percent at 60 Months post-transplant.

Figure IN 42. Graft survival among deceased donor intestine transplant recipients, 2011-2013, by metropolitan vs. non-metropolitan recipient residence
Graft survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for graft survival among deceased donor intestine transplant recipients, 2011-2013, by recipients

Figure IN 43. Graft survival among deceased donor intestine transplant recipients, 2011-2013, by recipients' distance from transplant center
Graft survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered. Distance is between the zipcode centroids of the TX center and the recipient's permanent residence, measured in nautical miles (NM).


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 56.0% from 109 patients at 2007 to 170 patients at 2018; the age greater than or equal to 18, in category increases by 101.9% from 162 patients at 2007 to 327 patients at 2018; the age less than 18, in to li category increases by 72.4% from 301 patients at 2007 to 519 patients at 2018; the age greater than or equal to 18, in to li category increases by 51.6% from 124 patients at 2007 to 188 patients at 2018; and the all category increases by 73.0% from 696 patients at 2007 to 1204 patients at 2018.

Figure IN 44. 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, 2016-2017, the age < 18, in group is 58.54 percent; the age >= 18, in group is 36.26 percent; the age < 18, in-li group is 46.03 percent; the age >= 18, in-li group is 24.59 percent; and the all group is 39.45 percent.

Figure IN 45. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by age and transplant type, 2016-2017
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 bar plot for incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by induction agent 2016-2017, the il2-ra group is 34.09 percent; the tcd group is 45.65 percent; and the no agents group is 32.93 percent.

Figure IN 46. Incidence of acute rejection by 1 year posttransplant among intestine transplant recipients by induction agent 2016-2017
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. If a recipient used both IL-2-RA and TCD agents, s/he will contribute to both of those cumulative incidence estimates.


A line plot for incidence of ptld among recipients of intestine transplant without liver by recipient ebv status at transplant, 2006-2016; 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 47. Incidence of PTLD among recipients of intestine transplant without liver by recipient EBV status at transplant, 2006-2016
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, 2006-2016; 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 48. Incidence of PTLD among recipients of intestine transplant with liver by recipient EBV status at transplant, 2006-2016
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 deceased donor intestine transplant recipients, 2011-2013, by age and transplant type; the age less than 18, in category decreases by 23.6% from 100 percent at 0 Months post-transplant to 76.4 percent at 60 Months post-transplant; the age greater than or equal to 18, in category decreases by 42.4% from 100 percent at 0 Months post-transplant to 57.6 percent at 60 Months post-transplant; the age less than 18, in to li category decreases by 30.0% from 100 percent at 0 Months post-transplant to 70 percent at 60 Months post-transplant; and the age greater than or equal to 18, in to li category decreases by 50.9% from 100 percent at 0 Months post-transplant to 49.1 percent at 60 Months post-transplant.

Figure IN 49. Patient survival among deceased donor intestine transplant recipients, 2011-2013, 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, 2018
Candidates waiting for intestines with and without liver on December 31, 2018, regardless of first listing date; multiple listings are collapsed. Distance is computed from candidate's home zip code to the transplant center.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Age: < 6 years 93 63.3% 59 60.8%
Age: 6-17 years 28 19.0% 18 18.6%
Age: 18-34 years 14 9.5% 11 11.3%
Age: 35-49 years 10 6.8% 9 9.3%
Age: 50-64 years 2 1.4% 0 0.0%
Sex: Female 85 57.8% 38 39.2%
Sex: Male 62 42.2% 59 60.8%
Race/ethnicity: White 94 63.9% 53 54.6%
Race/ethnicity: Black 27 18.4% 21 21.6%
Race/ethnicity: Hispanic 17 11.6% 16 16.5%
Race/ethnicity: Asian 5 3.4% 6 6.2%
Race/ethnicity: Other/unknown 4 2.7% 1 1.0%
Geography: Metropolitan 128 87.1% 75 77.3%
Geography: Non-metro 19 12.9% 22 22.7%
Distance: < 50 miles 34 23.1% 27 27.8%
Distance: 50-<100 miles 9 6.1% 8 8.2%
Distance: 100-<150 miles 10 6.8% 8 8.2%
Distance: 150-<250 miles 23 15.6% 14 14.4%
Distance: ≥ 250 miles 67 45.6% 35 36.1%
Distance: Unknown 4 2.7% 5 5.2%
All candidates 147 100.0% 97 100.0%



Table IN 2. Clinical characteristics of candidates on the intestine transplant waiting list on December 31, 2018
Candidates waiting for intestines with and without liver on December 31, 2018, 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 18 12.2% 4 4.1%
Diagnosis: Congenital SGS 30 20.4% 25 25.8%
Diagnosis: Non-congenital SGS 32 21.8% 25 25.8%
Diagnosis: Pseudo-obstruction 16 10.9% 3 3.1%
Diagnosis: Enteropathies 2 1.4% 6 6.2%
Diagnosis: Other/unknown 49 33.3% 34 35.1%
Blood type: A 53 36.1% 31 32.0%
Blood type: B 21 14.3% 17 17.5%
Blood type: AB 5 3.4% 2 2.1%
Blood type: O 68 46.3% 47 48.5%
IN medical urgency: Status 1 49 33.3% 50 51.5%
IN medical urgency: Non-urgent 38 25.9% 22 22.7%
IN medical urgency: Inactive 60 40.8% 25 25.8%
LI medical urgency: Status 1A 0 0.0%
LI medical urgency: MELD/PELD ≥ 35 28 28.9%
LI medical urgency: MELD/PELD 30-34 7 7.2%
LI medical urgency: MELD/PELD 15-29 35 36.1%
LI medical urgency: MELD/PELD < 15 2 2.1%
LI medical urgency: Inactive 25 25.8%
All candidates 147 100.0% 97 100.0%



Table IN 3. Listing characteristics of candidates on the intestine transplant waiting list on December 31, 2018
Candidates waiting for intestines with and without liver on December 31, 2018, regardless of first listing date; multiple listings are collapsed.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Transplant history: First 138 93.9% 78 80.4%
Transplant history: Retransplant 9 6.1% 19 19.6%
Wait time: < 1 year 37 25.2% 31 32.0%
Wait time: 1-< 2 years 23 15.6% 17 17.5%
Wait time: 2-< 3 years 16 10.9% 11 11.3%
Wait time: 3-< 4 years 14 9.5% 10 10.3%
Wait time: 4-< 5 years 11 7.5% 10 10.3%
Wait time: ≥ 5 years 46 31.3% 18 18.6%
Tx type: Intestine only 123 83.7% 0 0.0%
Tx type: Intestine-liver 0 0.0% 2 2.1%
Tx type: Intestine-pancreas 21 14.3% 0 0.0%
Tx type: Intestine-pancreas-liver 0 0.0% 86 88.7%
Tx type: Intestine-pancreas-liver-kidney 0 0.0% 9 9.3%
Tx type: Other 3 2.0% 0 0.0%
All candidates 147 100.0% 97 100.0%



Table IN 4. Intestine transplant waitlist activity, 2018
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 148 109
Patients added during year 62 74
Patients removed during year 63 85
Patients at end of year 147 98



Table IN 5. Removal reason among intestine transplant candidates, 2018
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 42 62
Living donor transplant 0 0
Patient died 4 10
Patient refused transplant 0 0
Improved, transplant not needed 5 7
Too sick for transplant 3 4
Other 9 2



Table IN 6. Demographic characteristics of intestine transplant recipients, 2018
Intestine transplant recipients, including retransplants. Distance is computed from recipient's home zip code to the transplant center.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Age: < 18 years 5 11.6% 32 52.5%
Age: 18-34 years 17 39.5% 8 13.1%
Age: 35-49 years 12 27.9% 14 23.0%
Age: 50-64 years 8 18.6% 6 9.8%
Age: ≥ 65 years 1 2.3% 1 1.6%
Sex: Female 22 51.2% 22 36.1%
Sex: Male 21 48.8% 39 63.9%
Race/ethnicity: White 27 62.8% 37 60.7%
Race/ethnicity: Black 7 16.3% 16 26.2%
Race/ethnicity: Hispanic 9 20.9% 5 8.2%
Race/ethnicity: Asian 0 0.0% 1 1.6%
Race/ethnicity: Other/unknown 0 0.0% 2 3.3%
Insurance: Private 20 46.5% 22 36.1%
Insurance: Medicaid 12 27.9% 27 44.3%
Insurance: Unknown 11 25.6% 12 19.7%
Geography: Metropolitan 34 79.1% 48 78.7%
Geography: Non-metro 9 20.9% 13 21.3%
Distance: < 50 miles 16 37.2% 20 32.8%
Distance: 50-<100 miles 7 16.3% 9 14.8%
Distance: 100-<150 miles 4 9.3% 8 13.1%
Distance: 150-<250 miles 3 7.0% 3 4.9%
Distance: ≥ 250 miles 13 30.2% 17 27.9%
Distance: Unknown 0 0.0% 4 6.6%
All recipients 43 100.0% 61 100.0%



Table IN 7. Clinical characteristics of intestine transplant recipients, 2018
Intestine transplant recipients, including retransplants. SGS, short-gut syndrome.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Diagnosis: Necrotizing enterocolitis 3 7.0% 9 14.8%
Diagnosis: Congenital SGS 1 2.3% 12 19.7%
Diagnosis: Non-congenital SGS 24 55.8% 14 23.0%
Diagnosis: Pseudo-obstruction 5 11.6% 3 4.9%
Diagnosis: Enteropathies 0 0.0% 3 4.9%
Diagnosis: Other/unknown 10 23.3% 20 32.8%
Blood type: A 17 39.5% 24 39.3%
Blood type: B 2 4.7% 5 8.2%
Blood type: AB 2 4.7% 3 4.9%
Blood type: O 22 51.2% 29 47.5%
Medical condition: Hospitalized in ICU 1 2.3% 9 14.8%
Medical condition: Hospitalized, not ICU 1 2.3% 9 14.8%
Medical condition: Not hospitalized 41 95.3% 43 70.5%
IN medical urgency: Status 1 36 83.7% 51 83.6%
IN medical urgency: Non-urgent 7 16.3% 10 16.4%
LI medical urgency: Status 1A 6 9.8%
LI medical urgency: MELD/PELD ≥ 35 16 26.2%
LI medical urgency: MELD/PELD 30-34 5 8.2%
LI medical urgency: MELD/PELD 15-29 27 44.3%
LI medical urgency: MELD/PELD < 15 6 9.8%
LI medical urgency: Unknown 1 1.6%
All recipients 43 100.0% 61 100.0%



Table IN 8. Transplant characteristics of intestine transplant recipients, 2018
Intestine transplant recipients, including retransplants.
Characteristic IN, N IN, Percent IN-LI, N IN-LI, Percent
Wait time: < 31 days 8 18.6% 11 18.0%
Wait time: 31-60 days 4 9.3% 16 26.2%
Wait time: 61-90 days 8 18.6% 7 11.5%
Wait time: 3-< 6 months 7 16.3% 6 9.8%
Wait time: 6-< 12 months 8 18.6% 7 11.5%
Wait time: 1-< 2 years 6 14.0% 9 14.8%
Wait time: ≥ 2 years 2 4.7% 5 8.2%
Donor type: Deceased 43 100.0% 61 100.0%
Transplant history: First 40 93.0% 53 86.9%
Transplant history: Retransplant 3 7.0% 8 13.1%
Tx type: Intestine only 37 86.0% 0 0.0%
Tx type: Intestine-liver-pancreas 0 0.0% 51 83.6%
Tx type: Intestine-liver 0 0.0% 3 4.9%
Tx type: Other 6 14.0% 7 11.5%
All recipients 43 100.0% 61 100.0%