Transplant for patients with severe Crohn’s?

December 17, 2012 at 7:28 pm 1 comment

Over the past few months, I’ve written posts about all sorts of new treatments being studied for IBD- bone marrow transplants and whipworms to name a few. Those sounded a little crazy to me but definitely intriguing. However, a new study published by the University of Pittsburgh Medical Center suggests that intestinal or multivisceral (three or more abdominal organs) transplants are effective treatments for patients with Crohn’s so severe that they no longer tolerate an IV nutrition.

As we all know, when Crohn’s is severe, its hard to absorb nutrients or even eat. For those who have irreversible intestinal failure, they may need to receive nutrition through a tube intravenously, known as total perenteral nutrition. According to the study, those who do not tolerate the IV nutrition are often referred for an intestinal transplant.

The study was conducted over 20 years and is the largest of its kind to study the benefits of transplants in end-stage Crohn’s patients.

Researchers at UPMC looked at 309 adult patients who received transplants between 1990 and June 2012. Of those studied, 57 had Crohn’s Diseases with irreversible intestinal failure and all failed IV nutritional therapy. Forty-three patients had just an intestinal transplant and two patients had a multivisceral graft including the stomach, duodenum (first part of small intestine), pancreas & intestine. Additionally,12 patients also required a liver transplant because of end-stage liver failure.

What’s astounding about this study is that, once the transplant was completed, patients were able to return to a normal oral diet and saw no recurrence of Crohn’s Disease.

Here’s a breakdown of the study’s data:

  • Survival rates of patients with transplants:
    • 90 percent at one-year
    • 74 percent at three years
    • 56 percent at five years
    • 43 percent at 10 years
  • Patients who also had a liver transplant had better long-term survival outcome with 57 percent at 10 years

This is pretty unbelievable- I had no idea that intestinal transplants were performed or even an option for Crohn’s patients. While I hope to never get to a stage where we are even considering it, it’s nice to know that there is an option that could help Crohnies live normal lives after years with a debilitating disease.

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