Introduction: In the Netherlands there is only 1 intestinal transplant (ITx) program and 2 centers for home parenteral nutrition. The number of patients as possible candidates for ITx, referred by different centers, is growing. Still the number of ITx is small. With this overview we want to present the case mix and complexity in adults over the last decade.

Methods: The nationwide online Dutch Registry of Intestinal Failure and Transplantation (DRIFT) was started (2011) to monitor intestinal failure patients, which combines data from patients of the University Medical Center Groningen (UMCG) and three more Dutch centers. In this retrospective overview we present a small but complex group of patients who were referred to or already known by the UMCG since November 2009 till now.

Results: During this last decade, 37 adult patients were referred to our nutritional support team for possible screening regarding ITx. After a first interview at the UMCG, 14 patients were not screened because enteral feeding or autologous reconstruction was possible. Others lacked condition or feared decreasing quality of life after transplantation. 23 patients were screened, of which ten patients were rejected after screening because of medical or psychological reasons. Eventually, only ten adult patients underwent ITx (of which 1 multivisceral transplantation, 2 ITx with abdominal wall, 2 ITx with kidneytransplantation) and three patients are still on the waiting list all with intestinal failure associated liver disease (IFALD) and severe venous access problems.

Conclusion: Over the last decade, a nationwide multidisciplinary approach of intestinal failure has proven to be successful so that only a limited amount of patients needed a transplant. However, the complexity in ITx candidates is increasing with more severe venous access problems and IFALD.