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Total intravenous nutrition causes fatal complications, small intestinal transplantation saves lives

On the 19th, Yadong Hospital announced the results of ten years of organ transplantation. The latest development is that it has been approved by the Department of Health and has become the first hospital in Taiwan that can perform small intestinal transplantation at any time. For congenital intestinal mucosal dysplasia, Or patients with small intestinal failure who have relied on total intravenous nutrition injection for a long time and have complications, can increase their chances of survival. Long-term reliance on total intravenous nutrition injections may cause fatal complications. Patients with such small intestinal failure can increase their chances of survival through small intestinal transplantation. (Photo provided/Dr. Chen Yun)

The development of small intestine transplantation in Taiwan lags far behind heart, liver, kidney and other transplants. Chen Yun, director of the Department of Pediatric Surgery at Yadong Hospital, said that the small intestine is an immune organ filled with lymphocytes. Therefore, rejection is very easy to occur after transplantation. In addition, there are only 10 to 20 patients requiring small intestine transplantation per year, making this transplantation a difficult and rare medical technology.

Dr. Chen Yun went abroad to learn this technology. In 2007, the Department of Health approved the implementation of clinical trials of small intestinal transplantation. She led the transplant team to successfully perform 5 human trials of small intestinal transplantation in 4 years, with a success rate of 100%. The half-year survival rate is 80%. The trial was successfully completed last year, making it the first hospital in China that can perform small intestine transplant surgeries after application. A total of 7 transplant cases have been successfully completed so far.

Dr. Chen Yun said that in the past, patients who had lost their small intestine function would not only supplement nutrition through total intravenous injection, but also undergo active rehabilitation, hoping to get the patients out of total intravenous injection as soon as possible. Nutrition. However, for patients with small intestinal failure, it is no longer possible to restore normal function, and long-term intravenous nutrition can lead to catheter infection, which can easily lead to severe sepsis or liver dysfunction, which may lead to life-threatening consequences. Small intestinal transplantation is the only chance to avoid fatal complications.

Dr. Chen Yun pointed out that 60% of patients in need of small intestinal transplantation are children, both at home and abroad. Some suffer from congenital intestinal mucosal aplasia that occurs at birth, and some suffer from short bowel syndrome. She said that the normal intestine is about 4 to 6 meters long, and children are also 2 to 3 meters long. However, with short bowel syndrome, the intestine is less than 50 centimeters, and children are even less than 10 centimeters. Of course, it is difficult to escape total intravenous nutrition injection. and facing the complications that come with it.

At present, the source of small intestine transplantation is still mainly donations from brain-dead patients. Dr. Chen Yun said that transplantation must find a donor with a similar body size. She described: "After the intestines are put in, the stomach must be able to be closed. "After surgery, patients need to use anti-rejection drugs for a long time and follow up on rejection regularly. The first transplant patient in China has survived successfully for more than 4 years; foreign studies show that the 5-year survival rate of small intestine transplant recipients can reach 50% to 60%.

The Department of Health is formulating the qualification accreditation method for hospitals and doctors. Dr. Chen Yun said that small intestinal transplantation is expected to be a routine surgery in the near future, giving patients with small intestinal failure a better chance of survival.