| Title: |
DOP127 Crohn’s disease and intestinal/multivisceral transplant: Who needs it and what are the outcomes? Experience from a High-Volume Centre |
| Authors: |
López Romero-Salazar, F; Butler, A; Amin, I; Massey, D; Neil, R; Woodward, J; Rutter, C |
| Source: |
Journal of Crohn’s and Colitis ; volume 20, issue Supplement_1 ; ISSN 1873-9946 1876-4479 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2026 |
| Description: |
Background Intestinal/multivisceral transplant (IT/MVT) remains the least frequent solid organ transplant, generally indicated in patients with severe complications of intestinal failure (IF) (1). Crohn’s disease (CD) may lead to IF through multiple mechanisms (2) yet published evidence on transplant outcomes in this setting is scarce. The primary aim of this study was to describe the outcomes of CD patients who underwent IT/MVT in our centre. Methods We retrospectively reviewed CD patients undergoing IT/MVT between 2008 and 2024 at Cambridge. Baseline CD characteristics, surgical history, indication for transplant (Table 1), and transplant characteristics and outcomes (Table 2) were collected. Survival was analysed using Kaplan–Meier and stratified by grafts including or not including liver (Figure 1). Results A total of 24 patients receiving 25 transplants (including 1 retransplant) were included. Fifty-four percent were male, most diagnosed at A2 age (58%), with ileocolonic disease (92%) and proximal involvement in 54%. 83% had stricturing or penetrating behaviour, with a median CD duration of 28.5 years. Prior therapy included immunomodulators (75%) and biologics (71%). Patients had a median of 5 previous surgeries and residual small bowel length of 70 cm; despite this, 58% had active CD at the time of transplant. Short bowel syndrome was the leading cause of IF (83%), and the main indication for transplant was IF-associated liver disease (48%). Median age at transplant was 50 years, with a median follow-up of 35 months; 56% received grafts excluding liver. Although 40% experienced rejection episodes, at last follow-up 88% had complete intestinal function without artificial nutritional support. Three patients developed CD recurrence, which did not result in graft loss. Overall survival is shown in Table 2; in patients with grafts excluding liver, survival was 100%, 90.9% and 90.9% at 1, 3 and 5 years, respectively. Conclusion Our experience shows that in patients with severe, long-standing CD ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ecco-jcc/jjaf231.164 |
| Availability: |
https://doi.org/10.1093/ecco-jcc/jjaf231.164; https://academic.oup.com/ecco-jcc/article-pdf/20/Supplement_1/jjaf231.164/66499624/jjaf231.164.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.9FF2AA67 |
| Database: |
BASE |