INTESTINAL TRANSPLANTATION

Currently, short bowel syndrome with intestinal failure (SBS-IF) patients with irreversible IF are destined for life-long parenteral support or intestinal transplantation.1

Based on efficacy and safety data, home parenteral nutrition is the primary treatment for SBS-IF, whereas intestinal transplantation is reserved for patients at risk of death due to severe complications arising from parenteral support or from the underlying gastrointestinal disease. The complexity of intestinal transplantation and high immunogenicity of the allograft hinders long-term success rates.1–4

Figure 6. 5-year survival rates for SBS-IF patients who were not candidates for intestinal transplantation, compared to those who received an intestinal transplant.1

Survival rates for SBS-IF patients on parenteral support who do not qualify for intestinal transplantation are higher than patients receiving intestinal transplants, with survival rates at 5 years for intestinal transplant recipients being 54%, compared to 87% for patients remaining on PS.1

Currently, short bowel syndrome with intestinal failure (SBS-IF) patients with irreversible IF are destined for life-long parenteral support or intestinal transplantation.1

Based on efficacy and safety data, home parenteral nutrition is the primary treatment for SBS-IF, whereas intestinal transplantation is reserved for patients at risk of death due to severe complications arising from parenteral support or from the underlying gastrointestinal disease. The complexity of intestinal transplantation and high immunogenicity of the allograft hinders long-term success rates.1–4

Figure 6. 5-year survival rates for SBS-IF patients who were not candidates for intestinal transplantation, compared to those who received an intestinal transplant.1

Survival rates for SBS-IF patients on parenteral support who do not qualify for intestinal transplantation are higher than patients receiving intestinal transplants, with survival rates at 5 years for intestinal transplant recipients being 54%, compared to 87% for patients remaining on PS.1

REVERSING INTESTINAL FAILURE

The main goal of SBS-IF treatment is to cure intestinal failure and achieve a full recovery by weaning off parenteral support.1

Chronic IF in patients with SBS-IF may be reversed through intestinal adaptation and/or intestinal rehabilitation programmes based on medical and surgical treatments. Weaning off from parenteral support in SBS-IF is more likely to occur in patients with partial or total colon continuity.1

However, complete weaning from parenteral support in SBS-IF patients is relatively unlikely to occur after 2–3 years have passed from the most recent intestinal resection.1

ADVANCES IN SBS-IF

There is a need for treatments in SBS-IF that increase intestinal rehabilitation and improve the absorptive capacity of the remaining intestine to reduce the need for parenteral support.2–4

Treatments that aim to increase intestinal rehabilitation and improve the absorptive capacity of the remaining intestine to reduce the need for parenteral support are becoming available or are in the late stages of clinical research.2,3,5,6

Certain hormones and trophic factors hold great promise in helping to improve intestinal function and potentially facilitate weaning off from parenteral support in SBS-IF patients1–3,5,6

Contact Takeda to find out more about treatment options for your patients with SBS-IF

Date of preparation: May 2020 C-ANPROM/INT//7387