For most people, eating is part of everyday life. Yet for patients with intestinal failure, “being able to eat” may be the most distant and precious wish.
Over the years, I have cared for children who lost most of their small intestine shortly after birth because of severe intestinal disease. From a very young age, their lives became inseparable from intravenous lines, central venous catheters, and total parenteral nutrition. While other children were learning to eat, go to school, and run freely, these children often had their lives interrupted by catheter-related infections, fever, and repeated hospitalizations. For their families, every fever felt like an alarm. Every problem with a central venous catheter could mean that one more lifeline had been lost.
Intestinal failure is still not well understood by the general public. These patients do not simply have a “poor digestive system.” Their small intestine can no longer absorb enough nutrients, water, and electrolytes to sustain life. They must rely on total parenteral nutrition to survive. Total parenteral nutrition has saved many lives, but long-term dependence may also lead to recurrent catheter-related bloodstream infections, liver injury, loss of venous access, nutritional and metabolic problems, and a heavy burden on daily life. When these complications occur repeatedly, intestinal transplantation may become an important treatment option for high-risk patients to regain a chance at life.
Gratitude Behind the Gift of Transplantation
Every May, Far Eastern Memorial Hospital holds its Thanksgiving and Memorial event for organ donation. When we speak about organ transplantation, the first feeling that comes to mind is gratitude.
We are grateful to deceased organ donors and their families, who, at the most difficult moment of life, chose to leave hope for others. The development of intestinal transplantation in Taiwan has been made possible by many quiet and selfless contributions: the trust of patients and families, the generosity of donor families, and the long-term dedication of medical teams who refused to give up.
Far Eastern Memorial Hospital has been devoted to intestinal transplantation and intestinal failure care for more than 20 years. From the early establishment of our intestinal failure care team, to the completion of deceased donor intestinal transplantation, the founding of our Intestinal Failure Care Center, and the gradual development of central venous catheter care, infection control, nutritional support, intestinal rehabilitation, immune monitoring, and long-term follow-up, we have learned one thing very clearly: intestinal transplantation is never the victory of a single operation. It is the result of a complete system of care.
Not One Operation, but a Complete Care System
The small intestine is an important immune organ. After transplantation, the risks of rejection and infection are high, and postoperative care is extremely complex. Whether a patient can do well in the long term depends not only on the surgery itself, but also on precise pre-transplant evaluation, control of catheter-related infections, reconstruction of nutrition, early detection of rejection, and whether the family can continue safe care after the patient returns home.
For this reason, the intestinal transplantation team at Far Eastern Memorial Hospital has never been a single-department team. It is a multidisciplinary team involving surgery, pediatric surgery, gastroenterology and hepatology, cardiovascular surgery, infectious diseases, intensive care, anesthesiology, nursing and dedicated ward care, nutrition, pharmacy, laboratory medicine, pathology, radiology, psychiatry, social work, and case management.
This is also why we place such strong emphasis on quality. Quality is not a slogan. It is found in the details we carry out every day in the ward: whether catheter care is standardized, whether infection rates are reduced, whether central venous access is preserved, whether nutritional prescriptions are individualized, whether patients can be followed after discharge, and whether families have someone to turn to when problems arise.
For patients with intestinal failure, quality is not merely a number on a report. It means one fewer infection, one fewer emergency visit, one more usable vein, and one more stable day at home.
Turning High-Risk Medicine into Sustainable Care Through 20 Years of Accumulation
In recent years, Far Eastern Memorial Hospital has achieved important results in intestinal transplantation. From 2007 to 2024, our hospital completed 38 cases of intestinal transplantation. The overall patient survival rates at 1, 3, and 5 years were 78.9%, 73.7%, and 71.1%, respectively. Looking at more recent outcomes from 2011 to 2024, the 1-year survival rate improved to 81.8%, and the 3- and 5-year survival rates both reached 75.8%.
These numbers represent more than surgical maturity. They reflect the gradual stabilization of team-based care, continued improvement in infection control, and the strengthening of postoperative monitoring and long-term follow-up. Behind every percentage is a patient, a family, and countless multidisciplinary discussions, bedside decisions, discharge plans, and follow-up efforts.
Living Donor Intestinal Transplantation: Opening Another Door for Patients Who Cannot Wait
Despite these advances, the availability of deceased donor organs remains limited. Children and smaller patients often face even greater challenges while waiting for a suitable organ. Some may lose the chance for transplantation before a suitable graft becomes available, because of recurrent infection, worsening liver function, or exhaustion of central venous access.
This is why Far Eastern Memorial Hospital initiated a clinical trial of living donor intestinal transplantation. Our goal was to open another door for high-risk patients with intestinal failure, under strict medical, ethical, and donor safety evaluation.
The meaning of living donor intestinal transplantation is not to romanticize the sacrifice of family members. Rather, it is a relay of love and professional responsibility, carried out under a protected and carefully regulated medical system. Every donor must undergo complete physical evaluation, 3D vascular and intestinal anatomical assessment, psychiatric and social work evaluation, and review by the medical ethics committee. For us, the rebirth of the recipient is important, but the safety and recovery of the donor are equally important.
Far Eastern Memorial Hospital has now completed 3 cases of living related intestinal transplantation, including one between sisters and two in which mothers donated to their children. Among these cases were children who had long depended on total parenteral nutrition, families who traveled across borders seeking care, and mothers who, after a long journey of caregiving, finally saw the possibility that their child might learn how to eat.
When one mother said, “I just hope my child can know what it feels like to eat,” we all understood that this was not only an operation. It was a family’s long-awaited wish for ordinary life.
Approval of Clinical Trial Closure by the Ministry of Health and Welfare: A Milestone and a New Beginning
We are grateful that our clinical trial of living donor intestinal transplantation has been approved for closure by the Ministry of Health and Welfare. For our team, this represents an important milestone. It shows that we have completed a full stage of validation in surgical technique, donor safety, recipient care, ethical review, and long-term follow-up.
Our hospital has also further submitted an application to the Ministry of Health and Welfare to have living donor intestinal transplantation recognized as a routine medical treatment. We hope that, after review and approval by the competent authority, eligible high-risk patients with intestinal failure may have access to a more timely and safe treatment option.
Intestinal transplantation is a difficult path. There is no single hero. There is only a team working together to complete every step well. From catheter care to nutritional reconstruction, from transplant surgery to post-discharge follow-up, from patient safety to quality of life, every step requires both quality management and clinical warmth.
We are not merely performing highly complex surgery. We are building a sustainable model of care: one that can care for patients, support families, protect living donors, and continue to improve.
Looking back on these 20 years during this month of gratitude, what I feel most deeply is still thankfulness. I am grateful to our patients, who have taught us humility. I am grateful to families, who have taught us what it means not to give up. I am grateful to donors, whose generosity allows life to continue. I am also grateful to every colleague at Far Eastern Memorial Hospital who has stood at the frontline to protect these patients.
For patients with intestinal failure, rebirth does not always begin with something dramatic. Sometimes it begins with the first sip of water, the first bite of food, or the first night of sleep without being connected to an intravenous line.
May we continue to work hard so that more patients can not only survive, but also return to their families, schools, workplaces, and lives. May the simple act of “being able to eat” once again become the most grounded happiness in their lives.
Far Eastern Memorial Hospital has been dedicated to small intestine transplantation for 20 years, completing 38 cases of selfless donation. On May 7, 2026, they successfully performed the first "living small intestine" transplant in Taiwan.
Gan's younger brother successfully recovered after undergoing a living small intestine transplant in Taiwan. He posed for a photo with his mother and Vice President Chen Yun, and expressed his gratitude to the medical team.