The Miami Experience With Almost 100 Multivisceral Transplants

A. G. Tzakis, T. Kato, S. Nishida, D. M. Levi, W. DeFaria, G. Selvaggi, D. Weppler, J. Moon, J. R. Madariaga, A. I. David, J. J. Gaynor, John F. Thompson, E. Hernandez, S. Tuteja, P. Tryphonopoulos, P. Ruiz

Research output: Contribution to journalArticle

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Abstract

We report our experience with 98 patients who received primary multivisceral transplantations. Three eras can be distinguished based on the evolution of technique, immunosuppression, and monitoring: August 1994 to December 1997 (first era); January 1998 to December 2000 (second era); and January 2001 to present (third era). Sixteen patients were transplanted during the first era, 18 during the second era, and 64 during the third era. Fifty-three patients are alive with a median follow-up of 37.5 months (range: 1 to 116 months). The leading cause of mortality was infection (n = 17), followed by rejection (n = 6). Seven patients required retransplantation and five of them subsequently died. The estimated 3-year survival was 25% ± 11% for era 1; 44% ± 12% for era 2; and 58% ± 7% for era 3. Additionally, 45.3% (29/64) of patients in the third era never developed rejection versus 23.5% (8/34) of patients in the first two eras combined. The percentage of patients who developed a moderate or severe rejection was significantly less in the third era compared with the first two eras combined, 31.6% (20/64) versus 67.6% (23/34). A comparison of the hazard rate of developing severe rejection showed a protective effect of the multivisceral graft (P = .0001). In conclusion, multivisceral transplantation is indicated for patients with short bowel syndrome and extended abdominal catastrophies. Evolution in surgical techniques, immunosuppression, and monitoring have improved patient survival, which is now similar to that of other complex solid organ transplants.

Original languageEnglish (US)
Pages (from-to)1681-1682
Number of pages2
JournalTransplantation Proceedings
Volume38
Issue number6
DOIs
StatePublished - Jul 2006
Externally publishedYes

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Transplants
Immunosuppression
Transplantation
Short Bowel Syndrome
Survival
Mortality
Infection

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Tzakis, A. G., Kato, T., Nishida, S., Levi, D. M., DeFaria, W., Selvaggi, G., ... Ruiz, P. (2006). The Miami Experience With Almost 100 Multivisceral Transplants. Transplantation Proceedings, 38(6), 1681-1682. https://doi.org/10.1016/j.transproceed.2006.05.015

The Miami Experience With Almost 100 Multivisceral Transplants. / Tzakis, A. G.; Kato, T.; Nishida, S.; Levi, D. M.; DeFaria, W.; Selvaggi, G.; Weppler, D.; Moon, J.; Madariaga, J. R.; David, A. I.; Gaynor, J. J.; Thompson, John F.; Hernandez, E.; Tuteja, S.; Tryphonopoulos, P.; Ruiz, P.

In: Transplantation Proceedings, Vol. 38, No. 6, 07.2006, p. 1681-1682.

Research output: Contribution to journalArticle

Tzakis, AG, Kato, T, Nishida, S, Levi, DM, DeFaria, W, Selvaggi, G, Weppler, D, Moon, J, Madariaga, JR, David, AI, Gaynor, JJ, Thompson, JF, Hernandez, E, Tuteja, S, Tryphonopoulos, P & Ruiz, P 2006, 'The Miami Experience With Almost 100 Multivisceral Transplants', Transplantation Proceedings, vol. 38, no. 6, pp. 1681-1682. https://doi.org/10.1016/j.transproceed.2006.05.015
Tzakis AG, Kato T, Nishida S, Levi DM, DeFaria W, Selvaggi G et al. The Miami Experience With Almost 100 Multivisceral Transplants. Transplantation Proceedings. 2006 Jul;38(6):1681-1682. https://doi.org/10.1016/j.transproceed.2006.05.015
Tzakis, A. G. ; Kato, T. ; Nishida, S. ; Levi, D. M. ; DeFaria, W. ; Selvaggi, G. ; Weppler, D. ; Moon, J. ; Madariaga, J. R. ; David, A. I. ; Gaynor, J. J. ; Thompson, John F. ; Hernandez, E. ; Tuteja, S. ; Tryphonopoulos, P. ; Ruiz, P. / The Miami Experience With Almost 100 Multivisceral Transplants. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 6. pp. 1681-1682.
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abstract = "We report our experience with 98 patients who received primary multivisceral transplantations. Three eras can be distinguished based on the evolution of technique, immunosuppression, and monitoring: August 1994 to December 1997 (first era); January 1998 to December 2000 (second era); and January 2001 to present (third era). Sixteen patients were transplanted during the first era, 18 during the second era, and 64 during the third era. Fifty-three patients are alive with a median follow-up of 37.5 months (range: 1 to 116 months). The leading cause of mortality was infection (n = 17), followed by rejection (n = 6). Seven patients required retransplantation and five of them subsequently died. The estimated 3-year survival was 25{\%} ± 11{\%} for era 1; 44{\%} ± 12{\%} for era 2; and 58{\%} ± 7{\%} for era 3. Additionally, 45.3{\%} (29/64) of patients in the third era never developed rejection versus 23.5{\%} (8/34) of patients in the first two eras combined. The percentage of patients who developed a moderate or severe rejection was significantly less in the third era compared with the first two eras combined, 31.6{\%} (20/64) versus 67.6{\%} (23/34). A comparison of the hazard rate of developing severe rejection showed a protective effect of the multivisceral graft (P = .0001). In conclusion, multivisceral transplantation is indicated for patients with short bowel syndrome and extended abdominal catastrophies. Evolution in surgical techniques, immunosuppression, and monitoring have improved patient survival, which is now similar to that of other complex solid organ transplants.",
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AU - Selvaggi, G.

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AU - David, A. I.

AU - Gaynor, J. J.

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