Surveillance with Protocol Biopsies for Rejection Significantly Impacts Survival Following Intestine Transplant
1Wayne State School of Medicine, Detroit, MI, 2Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, 3Department of Transplant Surgery, Henry Ford Hospital, Detroit, MI, 4Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI
Meeting: 2022 American Transplant Congress
Abstract number: 345
Keywords: Biopsy, Intestinal transplantation, Multivisceral transplantation, Protocol biopsy
Topic: Clinical Science » Small Bowel » 66 - Intestinal Transplantation and Rehabilitation
Session Information
Session Name: Intestinal Transplantation and Rehabilitation
Session Type: Rapid Fire Oral Abstract
Date: Monday, June 6, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 6:00pm-6:10pm
Location: Hynes Room 206
*Purpose: Frequent surveillance biopsy is required on the first month post intestinal transplant(IT) due to high-risk of acute rejection. However, the utility and the frequency of surveillance biopsy post 1-month is often determined by the physician and the institutions’ preference. Thus, we aimed to report IT outcomes and clinical significance of surveillance biopsy at a single tertiary care center.
*Methods: In this retrospective review of patients that underwent IT during the time-period between 08/2010 and 03/2020. Primary outcome was the correlation between increased protocol biopsies and mortality. Secondary outcomes included correlation between increased protocol biopsies and hospital re-admissions, length of hospital stay, and rate of biopsy proven rejection. Kaplan-Meier curves was used to perform the survival analysis at 6-month, 1-year, and 2-years post-transplant.
*Results: A total of 35 patients (mean age 47.6 ± 12.9 years, F 22 (63%)) underwent IT for: ischemic bowel 11 (31%), Chron’s disease 9 (25%), neuroendocrine tumor 6 (17%), trauma 3 (9%) and “others” 6 (17%), of which 14 (40%) were part of multivisceral organ transplant. During the first-year post-transplant, the median number of biopsies was 12 (IQR 6-30), with evidence of definite acute graft rejection in 40%, 27%, and 41% at the 1-3, 3-6, and 6-12 post IT time intervals, respectively. During the duration of the study, the mortality rate was 18/35 (51%) at a median time of 37 (12-60) months post IT, and a total of 8/35 (23%) patients underwent transplant enterectomy at a median time of 12 (8-36) months post-transplant. In general, there was a survival benefit for patients who had a total number of biopsies of ≥10 as compared to <10 biopsies at the time interval of 6-months post IT, (p=0.008). There was a non-significant trend with longer median length of hospital stay in patients with greater number of biopsies.
*Conclusions: Our results indicate evidence of survival benefit of increased protocol biopsies. Future studies with larger sample size are required to validate our results.
To cite this abstract in AMA style:
Sherwood JR, Ichkhanian Y, Beltran N, Nagai S, Jafri S. Surveillance with Protocol Biopsies for Rejection Significantly Impacts Survival Following Intestine Transplant [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/surveillance-with-protocol-biopsies-for-rejection-significantly-impacts-survival-following-intestine-transplant/. Accessed May 16, 2025.« Back to 2022 American Transplant Congress