Successful Intestinal Transplant Recipients Have Comparable Return To Work Rates As Other Solid Organ Transplants

Background: Intestinal transplantation (ITx) can extend survival in patients with advanced, recurrent PMP with no further cytoreductive options and with intestinal failure or symptomatic abdominal wall fistulation.However, patient selection is challenging.Many patients can live with advanced disease for some years.Referring too late in their disease process may render them unsuitable for transplant.Traditional anthropometrics like BMI do not predict body composition accurately in this population due to tumour mass.Methods: Referrals for PMP patients over a ten-year period (01/01/2015-31/12/2024) were reviewed.Sarcopenia was assessed using pre-transplant CT scans.Skeletal muscle area (SMA) was measured at the L3 level and adjusted for height to derive the skeletal muscle index (SMI).Anthropometric measures, survival post-referral and demographics were collected at the point of initial assessment.Results: 49 assessments were undertaken, of which 17/49 (35%) were transplanted, 22% were listed but not transplanted (usually due to deterioration or debulking at intention to transplant).The remaining 43% were never listed (not suitable).Breakdown of demographics and outcomes are shown in Table 1.Conclusions: ITx for PMP can significantly extend survival.Nutritional status relates to the decision to list for transplantation, and BMI cannot be relied upon.It is possible that anthropometrics could be used as a tool to guide listing decisions along with physiological tests such as CPET.Early referral allows adequate time for nutritional prehabilitation and counselling of patients when considering such a high-risk strategy.Improved awareness and timely referral could increase eligibility for this life-extending surgery at the point of disease deterioration.