Current status and future perspective of clinical intestinal transplantation

Results of intestinal transplant are improving in recent years and intestinal transplantation has been established as a therapeutic option for patients with intestinal failure associated with serious parenteral nutrition (PN) -related complications. According to the latest results from the Intestinal Transplant Registry (ITR), reported at the 11th International Small Bowel Transplantation Symposium held in Bologna, Italy in September 2009, the number of transplants was increasing every year and annually rose to 220 transplants per year. Recently one-year graft survival rates achieved more than 80% and most of current survivors had stopped parenteral nutrition and resumed normal daily activities. As of September 2010, 20 intestinal transplants have been performed for 18 patients with intestinal failure in Japan. Eleven living-related segmental intestinal transplants (including 1 combined liver-intestine transplant) were performed, whereas six patients have received intestinal grafts from cadaveric donors. Fourteen of 18 patients are currently alive after transplant. This article reviews current status and future perspective in management of intestinal failure and clinical intestinal transplantation on the basis of our experience and recent publications.