Successful human trial of small intestine transplantation to save the life of intestinal failure

In Taiwan Province Province, more than 100 patients depend on total parenteral nutrition and intravenous drip for survival every year because of end-stage intestinal failure. However, long-term intravenous nutrition will lead to catheter infection in most patients, and severe sepsis or abnormal liver function will be life-threatening. Small bowel transplantation is the only chance to save patients and their lives from the complications of total parenteral nutrition.

Chen Yun, director of surgery, said that Yadong Hospital had successfully performed 5 cases in the past 4 years, with a success rate of 100%. Miss Liu is the last patient who successfully accepted the intestinal transplantation test. (Photo courtesy of Yadong Hospital) In the United States, small bowel transplantation has become a routine operation in approved hospitals. There are 35 active medical centers in the world for small bowel transplantation, with a total of more than 2,600 cases. Small bowel transplantation has been reported sporadically in Asia, including Japan, Chinese mainland and South Korea. Chen Yun, director of surgery at Yadong Hospital, said that in China, small bowel transplantation was always in the stage of human trial. Now Yadong Hospital has completed the human trial scheme of small bowel transplantation, and five cases have been successfully carried out in the past four years, with a success rate of 100% and a half-year survival rate of 80%.

Yadong Hospital has completed five human trials, three of which were due to short bowel disease and two were due to poor intestinal peristalsis. The age of these five patients ranged from the youngest 8 years old (65,438+00 months) to the oldest 64 years old. After the operation, there is no need for intravenous support, and there is no problem in eating by mouth. The first little sister has been transplanted for four years, so it's no problem to have a bite to eat. Miss Liu was the last patient to receive the intestinal transplantation test. A few years ago, due to poor intestinal peristalsis, she had several operations and still could not eat at all. At present, I have been transplanted for about a year, and I have returned to school normally. I can get rid of the threat of total parenteral nutrition infection and the pain of abdominal distension, and I can also eat without restriction.

Small bowel transplantation usually takes 12 to 15 hours. The operation is from the abdomen, and the implanted new small intestine is placed in the abdominal cavity. The original small intestine should be removed, the mesenteric blood vessels should be connected with the abdominal blood vessels of the recipient, and a drainage tube should be placed in the abdominal cavity to discharge other body fluids. After the operation, enterostomy should be performed to help excrete feces and perform colonoscopy.

Director Chen Yun appealed that the indications of small bowel transplantation include ultrashort bowel disease (* * * the length of intestine is shorter than 50 cm, and that of children is less than 10 cm) and congenital intestinal mucosal dysplasia; Or intestinal failure, but many complications caused by long-term intravenous nutrition, such as abnormal liver function, main venous catheter embolism, sepsis caused by repeated venous catheterization, frequent dehydration and so on. Small bowel transplantation should be evaluated as soon as possible. The International Small Intestinal Transplantation Medical Association also suggested that medical institutions should refer patients with intestinal failure as soon as possible for rehabilitation and transplantation evaluation, so as to reduce the mortality rate of patients waiting for transplantation and improve the survival rate of patients.

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Illustration of small intestine transplantation. (Photo courtesy of Yadong Hospital)