Liver Failure From Ultra-Short Bowel Syndrome on the Intestinal Transplant Waiting List: A Retrospective Study

Area of Science:

• Gastroenterology
• Transplantation Surgery
• Organ Donation

Background:

• Intestinal failure (IF) necessitates intestinal transplantation (ITx) for affected patients.
• Cadaveric ITx opportunities are limited in Japan due to low organ donation rates.
• Optimal donor criteria and recipient prioritization for ITx remain undefined.

Purpose of the Study:

• To review cases of IF to identify patients who should be prioritized for ITx.
• To investigate the relationship between residual small bowel length and outcomes in IF patients awaiting ITx.

Main Methods:

• Retrospective study of IF patients registered for cadaveric ITx from January 2010 to November 2015.
• Data collected and analyzed from patient charts.

Main Results:

• Five IF patients were included, with conditions including aganglionosis, pseudo-obstruction, and prior graft loss.
• Two patients with <20 cm residual small bowel died from liver failure during the waiting period.
• Patients with <20 cm residual small bowel experienced catheter-related infections, leading to liver and renal failure.

Conclusions:

• Patients with ultra-short bowel (<20 cm residual small intestine) face a significantly higher risk of liver failure.
• Prompt referral to specialized hospitals offering ITx is crucial for IF patients with ultra-short bowel.
• Prioritizing ITx for patients with ultra-short bowel may improve survival rates.