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Related Experiment Video

Updated: Sep 13, 2025

Orthotopic Small Bowel Transplantation in Rats
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Ex Vivo Resection and Intestinal Autotransplantation: An International Multicenter Study.

Sho Fujiwara1, Akin Tekin2, Antonio D Pinna3

  • 1Department of Surgery, Columbia University, New York, NY.

Annals of Surgery
|August 1, 2025
PubMed
Summary

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Tailoring desensitization in intestinal transplants: C1q guided protocol for highly sensitized recipients.

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A New Era of Decision-making in Liver Transplantation: A Prospective Validation and Cost-effectiveness Analysis of FMN-guided Liver Viability Assessment During Normothermic Machine Perfusion.

Annals of surgery·2025
This summary is machine-generated.

Ex vivo resection and intestinal auto-transplantation (ERIA) offers a viable treatment for unresectable tumors, demonstrating low mortality and good long-term survival in this largest case series. This surgical approach provides hope for complex cases.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery
  • Transplantation Surgery

Background:

  • Ex vivo resection and intestinal auto-transplantation (ERIA) is a complex procedure for tumors deemed unresectable by conventional surgical techniques.
  • Limited data exists on ERIA outcomes, necessitating larger case series to establish its efficacy and safety.
  • This study represents the largest reported series evaluating ERIA for tumor management.

Purpose of the Study:

  • To assess the perioperative and long-term oncological outcomes of ex vivo resection and intestinal auto-transplantation (ERIA).
  • To evaluate the safety and effectiveness of ERIA in patients with complex, otherwise unresectable tumors.
  • To contribute to the limited existing data on ERIA by presenting a large, multicenter case series.

Main Methods:

Keywords:
R0 resectionWhipple procedureautotransplantationex vivo resection

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  • International multicenter retrospective analysis of patients undergoing ERIA between 1999 and 2024.
  • Exclusion of cases requiring liver auto-transplantation.
  • Analysis of perioperative mortality, R0 resection rates, overall survival (OS), and recurrence-free survival (RFS).

Main Results:

  • 35 patients analyzed; 85.7% achieved R0 resection. No 90-day mortality observed.
  • 1-, 3-, and 5-year overall survival rates were 87.7%, 70.3%, and 66.2%, respectively.
  • Highly malignant tumors showed lower survival rates compared to benign/low-grade tumors, but ERIA still provided acceptable outcomes.

Conclusions:

  • Ex vivo resection and intestinal auto-transplantation (ERIA) is a feasible surgical option for select patients with unresectable tumors.
  • The procedure is associated with low perioperative mortality and acceptable long-term oncological outcomes.
  • ERIA expands the therapeutic possibilities for challenging gastrointestinal tumor cases.