Impact of pediatric intestinal transplantation on intestinal failure in Japan: Findings based on the Japanese intestinal transplant registry

Introduction: We assessed the impact of intestinal transplantation on Japanese pediatric patients with intestinal failure with data from the Japanese intestinal transplant registry. Methods: Standardized forms were sent to all known intestinal transplantation programs, requesting information on transplants performed between 1996 and June 30, 2012. Patients younger than 18 years were analyzed. Patient and graft survival estimates were obtained using the Kaplan-Meier method. Results: Of the 14 intestinal transplants, 4 were deceased and 10 were living donor transplants. The primary indications were: short gut syndrome (n = 7), intestinal functional disorder (n = 6), and re-transplantation (n = 1). The overall 1- and 5-year patient survival rates were 77 and 57 %, respectively. In transplants performed after 2006 (n = 6), the one-year patient survival rate was 83 %, and the 5-year survival rate was 83 %. Graft one- and 5-year survival rates were 83 and 83 %, respectively. The living-related transplant survival rate was 80 % at 1 year and 68 % at 2 years, compared to 67 and 67 % for cadaveric transplant recipients. There were no statistically significant differences in patient (p = 0.88) and graft (p = 0.76) survival rates between living donor and cadaveric transplant recipients. All current survivors discontinued PN. Conclusion: Intestinal transplantation has become an effective therapy for patients with intestinal failure who cannot tolerate PN.