TABLE 1.
Propensity-Matched Cohort Analysis of Intestinal Transplantation From Living Versus Deceased Donors
| Statistic | LD-ITx (N=63) | DD-ITx (N=186) | P | |
|---|---|---|---|---|
| Variables used for matching | ||||
| Age at transplant (y) | ||||
| Median (min–max)(n) | 20 (0.6–57)(63) | 20 (0–73)(186) | 0.406 | |
| Weight at transplant (kg) | ||||
| Median (min–max)(n) | 42 (5–93)(43) | 45 (5–107)(126) | 0.775 | |
| Recipient gender | — | — | — | 0.954 |
| Female | n/N (%) | 26/63 (41) | 76/186 (41) | — |
| Male | n/N (%) | 37/63 (60) | 110/186 (59) | — |
| Region | — | — | — | 0.447 |
| Europe | n/N (%) | 6/62 (10) | 13/180 (7) | — |
| North America | n/N (%) | 38/62 (61) | 126/180 (70) | — |
| Middle-East/Asia | n/N (%) | 18/62 (29) | 41/180 (23) | — |
| Indication | ||||
| Short bowel syndrome | n/N (%) | 53/63 (84) | 143/186 (77) | 0.286 |
| Motility disorder | n/N (%) | 5/63 (8) | 20/186 (11) | 0.633 |
| Tumor | n/N (%) | 3/63 (5) | 2/186 (1) | 0.105 |
| Other | n/N (%) | 1/63 (2) | 12/186 (6) | 0.194 |
| Mucosal Defect | n/N (%) | 1/63 (2) | 5/186 (3) | >0.999 |
| Retransplant | n/N (%) | 0/63 (0) | 4/186 (2) | 0.575 |
| Graft Number | — | — | — | 0.972 |
| 1 | n/N (%) | 57/60 (95) | 167/176 (95) | — |
| 2 | n/N (%) | 3/60 (5) | 9/176 (5) | — |
| Pretransplant status | — | — | — | 0.138 |
| Home | n/N (%) | 33/63 (52) | 112/185 (60) | — |
| Hospitalized | n/N (%) | 29/63 (46) | 73/185 (40) | — |
| ICU | n/N (%) | 1/63 (2) | 0/185 (0) | — |
| ABO Compatibility | — | — | — | 0.838 |
| Identical | n/N (%) | 37/41 (90.2) | 98/110 (89) | — |
| Compatible | n/N (%) | 4/41 (9.8) | 12/110 (11) | — |
| MIS | ||||
| None | n/N (%) | 3/63 (5) | 5/186 (3) | 0.420 |
| Anti-Lymphocyte | n/N (%) | 19/63 (30) | 49/186 (26) | 0.557 |
| Mycophenolate Mofetil Cept/Myfortic | n/N (%) | 18/63 (29) | 38/186 (20) | 0.181 |
| Tacrolimus | n/N (%) | 52/63 (82) | 159/186 (86) | 0.574 |
| Orthoclone | n/N (%) | 6/63 (10) | 12/186 (6) | 0.416 |
| Cyclophosphamide | n/N (%) | 3/63 (5) | 3/186 (2) | 0.159 |
| Cyclosporine | n/N (%) | 3/63 (5) | 6/186 (3) | 0.572 |
| Steroids | n/N (%) | 51/63 (81) | 143/186 (77) | 0.501 |
| Rapamycine | n/N (%) | 6/63 (10) | 17/186 (9) | 0.928 |
| IL-2 Antagonist | n/N (%) | 9/63 (14) | 25/186 (13) | 0.866 |
| Other | n/N (%) | 14/63 (22%) | 35/186 (19%) | 0.557 |
| Year of tranplant | — | — | — | 0.231 |
| ≤ 1994 | n/N (%) | 2/63 (3) | 10/186 (5) | |
| 1995–1999 | n/N (%) | 15/63 (24) | 32/186 (17) | |
| 2000–2004 | n/N (%) | 23/63 (36) | 51/186 (27) | |
| 2005–2009 | n/N (%) | 14/63 (22) | 56/186 (30) | |
| 2010–2014 | n/N (%) | 5/63 (8) | 30/186 (16) | |
| 2015–2019 | n/N (%) | 4/63 (6) | 7/186 (4) | — |
| Variables not used for matching | ||||
| Height at transplant (cm) | ||||
| Median (min–max)(n) | 160 (61–185)(41) | 157 (58–193)(118) | 0.730 | |
| BMI at transplant (kg/m²)(>18y) | ||||
| Median (min–max)(n) | 20 (14–29)(24) | 22 (14–37)(65) | 0.139 | |
| HLA mismatch | — | — | — | <0.001 |
| ≤3 | n/N (%) | 36/39 (92) | 21/112 (19) | — |
| >3 | n/N (%) | 3/39 (8) | 91/112 (81) | — |
| Primary outcome | ||||
| Acute rejection | ||||
| n/N (%) | 16/34 (47) | 25/49 (51) | 0.723 | |
| Patient Survival | — | — | — | 0.826 |
| 1 y | Est. (95% CI) | 74 (61;83) | 80 (74;85) | — |
| 5 y | Est. (95% CI) | 50 (36;62) | 48 (40;55) | — |
| 10 y | Est. (95% CI) | 46 (32;58) | 39 (31;46) | — |
| Secondary Outcome | ||||
| Patient status | — | — | — | 0.920 |
| Alive (functioning graft) | n/N (%) | 17/63 (27) | 55/186 (30) | — |
| Graft removed | n/N (%) | 12/63 (19) | 33/186 (18) | — |
| Death/Lost to follow-up | n/N (%) | 34/63 (54) | 98/186 (53) | — |
| Graft function | — | — | — | 0.127 |
| Full function | n/N (%) | 21/30 (70) | 56/103 (54) | — |
| Partial or no function* | n/N (%) | 9/30 (30) | 47/103 (46) | — |
| Cause for graft removal | — | — | — | 0.082 |
| Rejection | n/N (%) | 13/18 (72) | 45/51 (88) | — |
| PTLD | n/N (%) | 1/18 (6) | 2/51 (4) | — |
| Poor graft function | n/N (%) | 1/18 (6) | 2/51 (4) | — |
| Infection (non-PTLD) | n/N (%) | 0/18 (0) | 1/51 (2) | — |
| Surgical | n/N (%) | 0/18 (0) | 1/51 (2) | — |
| Other | n/N (%) | 3/18 (17) | 0/51 (0) | — |
| Graft Survival (nonsensitized to death) | — | — | — | 0.956 |
| 1 Year | Est. (95% CI) | 60 (47;71) | 69 (62;75) | — |
| 5 Year | Est. (95% CI) | 41 (28;52) | 36 (29;43) | — |
| 10 Year | Est. (95% CI) | 33 (21;45) | 26 (20;34) | — |
| Kidney function | — | — | — | — |
| Need for RRT | n/N (%) | 2/24 (8) | 3/60 (5) | 0.621 |
| Dialysis | n/N (%) | 1/2 (50) | 1/3 (33) | >0.999 |
| Kidney transplant | n/N (%) | 1/2 (50) | 2/3 (67) | >0.999 |
| No RRT described | n/N (%) | 0/2 (0) | 0/3 (0) | >0.999 |
| Creatinine at follow-up (mg/dl)(>18y) | ||||
| Median (min-max)(n) | 0.88 (0.25–4.3)(11) | 1.1 (0.58–3.05)(13) | 0.768 | |
| Complications | ||||
| PTLD | n/N (%) | 1/38 (3) | 7/116 (6) | 0.680 |
| Infection | n/N (%) | 5/63 (8) | 8/186 (4) | 0.324 |
*
Dependence on parenteral nutrition or intravenous fluids.
BMI indicates body mass index; CI, confidence interval; DD-ITx, deceased donation intestinal transplantation; ICU, intensive care unit; IL-2, interleukin 2; ITx, intestinal transplantation; LD-ITx, living donation intestinal transplantation; MIS, maintenance, immunosuppression; PTLD, posttransplant lymphoproliferative disease; RRT, renal replacement therapy.