多臓器同時移植
A few weeks back, an article about a multiple-organ transplant to be performed on a Japanese infant caught my eye. I hadn’t heard much more about it, but today, tucked in between the more lurid stories in the Mainichi, is this update:
Five months after being born, the baby boy was diagnosed as suffering from twisted intestines, and his internal organs began to deteriorate.
His parents arranged for Yosuke to undergo a transplant of his stomach, pancreas, spleen, liver, and the large and small intestines at the University of Miami Jackson Memorial Center on Christmas Eve.
That’s pretty much everything down there, isn’t it, except his gall bladder and kidneys? The little guy’s recovering well, so they expect to release him soon (the article seems to imply but doesn’t actually say that it will be earlier than usual). And naturally, they have to watch for signs of rejection. It’s good to hear things are going along smoothly so far, though.
I wondered about that. I mean, I didn’t know that was true even for adult patients with just one organ transplanted–I assume everyone’s included in that stat?–but it did seem that having so many done would be really tricky, even if they all came from the same infant.
Well, it’s hard to say. Survival rates vary greatly depending on the organ transplanted. The highest survival rate is for kidney transplants. UNOS only tracks data out to 5 years, but the fact that there’s no 10 year stats in the public domain says something, doesn’t it?
As for multiple organs, I’ve never seen data on a 5 organ transplant – there haven’t been enough done to make any statistical conclusions. However, the 5 year survival rate for heart / lung dual transplants is not statistically different from lung (the trickier organ) transplant alone: both are about ~44%. Kidney and kidney / pancreas have 5 year survival rates of 70% and 74% respectively. That the dual transplant in this case has a better survival rate is proabably related to the pancreas tranplant helping to eliminate diabetes, which is usually the reason someone needs a kidney in the first place. It seems having one chunk of foreign tissue planted inside you has about the same physiological effect as having two. Five might be a different story, though.
Intestinal transplants have about a 40% 5 year survival rate, but it’s lower in males (~37%) than females (~44%). I don’t know if the kid’s young age will help or hurt his graft survival chances.
I’m not searching especially hard, but I haven’t seen stories about this particular case that give stats; probably, all they can do is wait and see. As you say, this scale of operation can’t be all that common, so the data they have might not be generalizable, anyway. It’s nice to think he’s been given at least a shot.
I really feel for him and his parents. The immunosuppresive regimen he’ll need to stave off rejection is going to make childhood a living hell.
I thought of another reason Koseirodosho might not want to pay for this: life expectancy. Although most transplant patients survive 5 years, 10 years is doing really well and 20 is a miracle.