Intestine remains the least frequently transplanted solid organ, although the survival and quality-of-life benefits of transplant to individuals with irreversible intestinal failure have been well demonstrated. The trend seen over the past 15 years of fewer listings and fewer transplants appears to be continuing, most noticeably in infants, children, and adolescents. There were only 146 additions to the intestine waiting list in 2022, and the proportion of adult candidates continues to increase, so that now 61% of the intestine waiting list are adult candidates. There has been little change in the distribution by sex, race and ethnicity, or primary diagnosis on the waiting list, or for those receiving transplant. The transplant rate for adults has decreased to 55.6 transplants per 100 patient-years, but the pediatric transplant rate remains relatively stable at 22.8 transplants per 100 patient-years. The decrease in transplant rates for adults is primarily the result of falling rates for those listed for combined intestine-liver, and this is reflected in the pretransplant mortality rates, which are twice as high for candidates in need of both organs compared with those listed for intestine alone. Overall, intestine transplant numbers decreased to a total of 82 intestine transplants in 2022, only one above the lowest ever value of 81 in 2019. No major changes were seen in the immunosuppression protocols, with most recipients having induction therapy and tacrolimus-based maintenance. Graft failure rates appear to have improved at 1, 3, and 5 years for intestine without liver, but this is not seen for combined intestine-liver. Graft and patient survival are better for pediatric recipients compared with adult recipients for both liver-inclusive and liver-exclusive transplant. Rates of posttransplant lymphoproliferative disorder are higher for recipients of intestine without liver.

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OPTN/SRTR 2022 年度数据报告：肠道

尽管已经充分证明了对患有不可逆性肠衰竭的个体进行移植对生存和生活质量的益处，但肠道仍然是最不常移植的实体器官。过去 15 年中上市数量减少和移植数量减少的趋势似乎仍在持续，尤其是在婴儿、儿童和青少年中。 2022年肠道候补名单仅新增146人，而成人考生的比例持续增加，以至于现在肠道候补名单中61%是成人考生。等待名单上的性别、种族和民族、初步诊断或接受移植的人的分布几乎没有变化。成人移植率已下降至每 100 患者年 55.6 例移植，但儿童移植率保持相对稳定，为每 100 患者年 22.8 例移植。成人移植率的下降主要是由于肠肝联合移植率下降的结果，这反映在移植前死亡率上，需要两种器官的候选人的移植前死亡率是肠肝联合移植者移植前死亡率的两倍。独肠。总体而言，2022 年肠道移植数量减少至 82 例，仅比 2019 年历史最低值 81 例高出 1 例。免疫抑制方案没有发生重大变化，大多数受者接受诱导治疗和基于他克莫司的维持治疗。对于没有肝脏的肠，移植失败率似乎在 1 年、3 年和 5 年有所改善，但对于肠-肝联合的情况则没有看到这种情况。与成人接受者相比，无论是肝脏移植还是单纯肝脏移植，儿童接受者的移植物和患者存活率都更好。对于没有肝脏的肠道受者来说，移植后淋巴增殖性疾病的发生率较高。