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Published on: August 13, 2014
Deceased donor non-composite split liver and intestinal transplantation for children
Tatsuya Okamoto1,2, Eri Ogawa3,4, Hideaki Okajima5
1Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan. okamotot@kuhp.kyoto-u.ac.jp.
Insights
This study reports the first simultaneous liver and intestinal transplants in Japan for infants with intestinal failure-associated liver disease (IFALD). The procedure, using deceased donor organs, achieved positive outcomes in two premature infants.
Area of Science:
- Pediatric Surgery
- Transplantation Medicine
- Gastroenterology
Background:
- Parenteral nutrition in children with intestinal failure can lead to liver damage, known as intestinal failure-associated liver disease (IFALD).
- IFALD often necessitates combined liver and intestine transplantation, a procedure with limited reported cases globally and none previously in Japan.
- Simultaneous deceased donor liver-intestine transplantation is a complex procedure with unclear details in the Japanese context.
Purpose of the Study:
- To report the first successful simultaneous split liver and intestinal transplantation in Japan for premature infants with IFALD.
- To describe the surgical and perioperative management strategies employed in these pioneering cases.
- To contribute to the understanding and advancement of combined organ transplantation for pediatric intestinal failure.
Main Methods:
- Performed simultaneous split liver and intestinal transplantation in two premature infants diagnosed with IFALD.
- Utilized grafts from identical deceased donors for both organs.
- Focused on meticulous surgical technique and comprehensive perioperative care.
Main Results:
- Achieved successful outcomes in both infant recipients following the combined liver and intestinal transplant.
- Demonstrated the feasibility of simultaneous deceased donor liver-intestine transplantation in Japan.
- Established a foundation for future similar procedures in the country.
Conclusions:
- Simultaneous split liver and intestinal transplantation from deceased donors is a viable option for Japanese infants with IFALD.
- Careful surgical and perioperative management are critical for successful outcomes in this complex procedure.
- These cases represent a significant advancement in pediatric transplantation in Japan.
Abstract:
Children with intestinal failure suffer liver damage associated with parenteral nutrition: a condition known as intestinal failure-associated liver disease (IFALD), which requires transplantation of both liver and intestine. In many countries, simultaneous transplantation of these two organs is performed using grafts from a deceased donor, but there have been no such cases in Japan, and the details of the procedure are not clear. Recently, we performed simultaneous split liver and intestinal transplantation in two premature infants with IFALD, using organs from identical deceased donors and achieved good results. These are the first two cases of this procedure being performed in Japan. We report these cases and discuss the important aspects of the surgical and perioperative management.
