New Approach Improves Intestine Transplants

By using fewer drugs and lower doses of immuno-suppressive agents, doctors have found they can lower the rate of rejection and infection and still lessen immunosuppression in patients with intestine transplants.

To date, more than 240 patients have received 259 transplants involving the small intestine at the Medical Center of the University of Pittsburgh (PA, USA). One-year survival for patients transplanted within the last five years has improved to 90%, compared to 72% in 1990 and 1995. The new approach has many of the transplanted patients taking a single antirejection drug as few as one to three times a week, and the rate of opportunistic infection has dropped from 45% in 1990 to 9%. Meanwhile, the rate of rejection has dropped from 88% to 40%.

"The improvements we have seen in survival rates are clearly related to the changes we've made with respect to immunosuppression,” said Geoffrey Bond, M.D., assistant professor of surgery at the university's Starzl Transplantation Institute. "As we have better come to understand the rejection process and the unique characteristics of the small intestine, we have been able to make important refinements to therapy.” The clinical results of the new approach were presented at the VIII International Small Bowel Transplant Symposium in Miami (FL, USA).