J.Jpn. Surg. Soc.. 121(2): 190-195, 2020

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INTESTINAL TRANSPLANTATION

The prognosis of patients with intestinal failure, such as short bowel syndrome and intestinal motility disorder, markedly improved after the development of parenteral nutrition. However, patients are often at risk of the loss of central line access and intestinal failure-related liver disease. In those cases, intestinal transplantation is required, but only 30 intestinal transplants had been performed in Japan as of the end of 2018. However, in 2018, intestinal transplantation was approved for insurance coverage, eliminating the economic burden. However, there are still many issues. Additional clinical research is necessary to improve long-term graft survival. As part of intestinal rehabilitation programs, transplantation should be considered together with medical and other surgical treatment to avoid missing the window of opportunity for receiving donor intestines. The Japanese Intestinal Transplant Association was renamed the Japan Intestinal Rehabilitation and Transplant Association in 2019 and clarified its position as a part of comprehensive treatment for intestinal failure. In young children, intestinal failure often accompanies liver failure, and simultaneous transplantations of the liver and intestine and multivisceral transplants are performed abroad. In the future, it will be necessary to establish a system in Japan that allows multivisceral transplantations for patients with liver failure.

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