Establishment Of Registry And Follow-up System And Monitoring Of Immunosuppressive Treatment In Intestinal Transplantation

1. Establishment of registry and follow-up system in intestinal transplantationObjective:To set up the follow-up and registry system in intestinal transplantation. According to the experience of well-established organ transplantation registry system all over the world and current situation of intestinal transplantation in our hospital, we also investigated the principle and methods of this system.Method:Learning from the principle of establishment of Intestinal Transplant Registry(ITR), Organ Procurement and Transplantation Network (OPTN), Scientific Registry of Transplant Recipients (SRTR), United Network for Organ Sharing (UNOS)and Chinese Scientific Registry of Kidney Transplantation (CSRKT), China Liver Transplant Registry (CLTR), China Intestinal Transplant Registry, collecting the information of follow-up in our hospital, we constructed the rationally monitored methods, index and frequency, and established the clinical data and follow-up database.Results:The system contains the important events, including the demographic characteristics of candidates, acceptants and donors, the situation of peroperative period and survival analysis and so on. Modification and complement of system should be performed according to the problem in application. The set up of follow-up and registry system in intestinal transplantation could make the data input convenient and quick, and inquire the information exactly.Conclusion:The characters of the system should be actual, practical, scientific and readable. The system should include efficiently monitoring index and methods to discover and solve the problem in time. We must continue to discover the insufficiency and modification of the monitoring methods, further improve the follow-up and registry system of intestinal transplantation.2. Following up and monitoring of immunosuppressive treatment in intestinal transplantationObjective:To evaluate the rationality of monitoring index and methods of immunosuppressive treatment in intestinal transplantation and to establish Intestinal Transplant Registry.Method:The clinic data of 16 patients intestinal transplantation between 1994 and 2009 were analyzed retrospectively. The patients were divided into 3 periods according to different immunosuppressive strategy. The monitoring frequency and index of implications of intestinal transplantation, such as rejection, infection, toxic and side-effect, were evaluated. The monitoring index were examined in the variation of lymphocyte, concentration of tacrolimus, and function of liver and kidney on postoperative 1 year.Results:The follow-up period was 3-26 months. During Eraâ… and Eraâ…¡, the survival time of grafts was under 1 year. During Eraâ…¢, except one patient died of MODS on POD12, the survival rate of five patients and grafts were both 100% at 6-month, 83.33% at 1-year, respectively. The lymphocyte lost quickly on postoperative 1 to 2 month(p<0.05)and recovered to normal level generally on postoperative 6 month(p>0.05). The increased frequency of rejection happened on postoperative 7 to 12 month and we need to increase the frequency of rejection monitoring and to carry out the closure of abdominal stoma on postoperative 6 month. We can check out the mild rejection without symptom above 70 percent. There were no increased infection and side-effect in the early period.Conclusion:On operative 1-year, the following up and monitoring of immunosuppressive treatment in intestinal transplantation are rational, and may have a positive effect on the treatment in such patients. In addition, we may have acquired scientific evidence to establish Intestinal Transplant Registry.