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Small bowel I
PTU-149 Cambridge-Miami risk assessment for intestinal transplantation
  1. C Pither1,
  2. R Sivaprakasam2,
  3. H Takahashi3,
  4. S Nishida3,
  5. A Butler2,
  6. J Moon3,
  7. M D Dawwas1,
  8. S Gabe4,
  9. N Jamieson2,
  10. J Woodward5,
  11. E Island6,
  12. A Tzakis6,
  13. S J Middleton1
  1. 1Gastroenterology, Cambridge University, Cambridge, UK
  2. 2Transplantation Surgery, Cambridge University, Cambridge, UK
  3. 3Transplantation Surgery, Department of Surgery, University of Miami School of Medicine, Miami, USA
  4. 4Intestinal Failure Unit, St Mark's Academic Centre, London, UK
  5. 5Gastoenterology, Cambridge University, Cambridge, UK
  6. 6Transplantation Surgery, Department of Surgery, University of Miami School of Medicine, Miami, USA

Abstract

Introduction The Cambridge-Miami (CaMi) preoperative risk assessment score has been previously validated in a small cohort and accurately predicted the survival after intestinal transplantation. We undertook a further validation in a larger cohort of patients.

Methods Co-morbidity and lost venous access are used as putative preoperative risk factors, each scored 0–3 for severity. Patients (72 adults (M:F, 33:39) received an isolated intesinal graft (27), or a cluster graft including intestine (45).

Results Mean (SD) survival was 1501 (1444) days. The Kaplan–Meier analysis of survival revealed a significant inverse association between survival and CaMi score [logrank test for trend, p<0.0001]. Patients were grouped into CaMi scores of 0 and 1, 2 and 3, 4 and 5, 6 and above, and HR [95% CIs] for death (compared to group 0+1) was found to increase as the CaMi score increased; 1.945 [0.7622 to 5.816], 5.075 [3.314 to 36.17] and 13.77 [463.3 to 120100] respectively and was significantly greater than group 0+1 at group 4+5 (p<0.0001).

Conclusion The ability to predict survival from the CaMi score might allow better patient selection, and identify patients for earlier transplantation.

Competing interests None declared.

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