Dear Colleagues, I’m honoured for being elected to serve you as your new President.
The list of past Presidents includes prominent figures in the field like, Andreas Tzakis, David Grant, Thomas Fishbein, Kareem Abu-Elmagd, Douglas Farmer, Debra Sudan, George Mazariegos, and Simon Horslen; and with them an overwhelming feeling of responsibility and commitment to this Association, which for the first time chose a president from a different region, Latin América.
I joined the SBTS in 2001 and over the last 20 years, I witnessed a significant series of changes including a slow but progressive improvement in patients and graft survival; the development of rehabilitation surgery in adults and children, as well as the increasing use of enterohormones as part of the medical rehabilitation. These achievements were only possible due to acceptance of having a comprehensive and multidisciplinary approach for the care of our patients.
The daily interaction between physicians, surgeons and allied health professionals has become the strongest and leading force to continue improving patient care worldwide, and which inspired the leading council to modify our name to Intestinal Rehabilitation and Transplant Association in 2015.
Over the last 6 years, the global medical and surgical intestinal rehabilitation leaders helped to consolidate our association. In the coming years, we will face the challenge to better understand the current availability of rehabilitation and transplant programs worldwide; of providing better options to patients living in underserved areas of the globe, and of becoming "The Association” that will provide guidelines to rule-out the field in order to sustain its mission: optimizing the lives of intestinal failure patients worldwide.
Having worldwide registries for adults and children will help to better understand individual needs. Today there are countries lacking Home Parenteral Nutrition Programs, others do not have rehabilitation surgery, and less have the possibility of offering transplant services. We have the responsibility of working to start reducing this inequity for the benefit of our patients.
I’m proud of the group of executive leaders and council. With them, we will outreach countries, programs, and physicians, in order to better serve them by increasing the number of members and centers joining IRTA and advancing the support of professionals working in the field of rehabilitation and transplantation by increasing education, research and advocacy. We will be their mentors.
Transplantation surgery will remain as our main area of work. The International Intestinal Transplant Registry, the development of multicenter, basic sciences and communication committees together with new task forces, will focus on trying to better understand the current causes of graft loss in order to improve long term graft survivals.
Excellence, Collaboration, Advocacy and Integrity will only continue being our core values if we all commit to serve all members and patients by creating a global community of practice.
I’m pleased to serve and work for you.
Alan Buchman, Loris Pironi, and Stephane Schneider have petitioned the Medical and Scientific Committee (MASC) of the WHO to accept Intestinal Failure-Associated Liver Disease (IFALD) and sub-divisions of the newly approved Short Bowel Syndrome code into SBS with colon in continuity and SBS without colon in continuity as new diagnostic codes for ICD-11 (effective January 1, 2022). If accepted by the WHO, the additional codes would be approved in early 2022 and added to ICD-11. It is important that we show our support by voting to "agree" with this proposal.
In order to do so, you will need to go to the WHO's ICD-11 webpage and create an account and search for "short bowel syndrome" in the search box. This will show support that member countries should see so that they vote affirmative in early 2021 to finalize the codes. You will need to do the same for Intestinal Failure-Associated Liver Disease, which is listed under “Specific Liver Disease” rather than Intestinal Failure at the WHO’s request. Definitions are included.
A proposal was also submitted to the CDC for updating the ICD-10CM with the newly proposed codes as well. We are waiting to learn when the new codes for Short Bowel Syndrome and Intestinal Failure will become effective in ICD-10CM. IRTA will be sending a letter of support to the CDC on behalf of our members. It will be important for the IRTA to stay involved in this process.
If you have specific questions or comments, please e-mail Alan Buchman directly at: firstname.lastname@example.org
Let’s vote and support the initiative.
Prof. Gabriel Gondolesi MD, MAAC, FACS
The IFR is endorsed by the North American Society for Pediatric Gastroenterology and Nutrition (NASPGHAN) and the American Society for Parenteral and Enteral Nutrition (ASPEN)
The IFR is supported by non-restricted and education grants by Takeda LTD and Stanford University & the Lucile Packard Children’s Hospital
As you will certainly know, non-vascularized rectus fascia (NVRF) transplantation was first described in 2009 (Gondolesi et al. Transplantation 2009;87:1884–8) as a novel technique to close the abdominal wall after solid organ transplantation. By using this technique, extensive abdominal wall repair was avoided and the technique is gaining interest worldwide. Later the vascularized fascia transplant was introduced as alternative (VRF).
So far, experience with (N)VRF transplantation is scarcely reported. At our transplant center in Leuven, Belgium, we performed our first case of NVRF transplant in September 2020. Dr. Nele Van De Winkel is an abdominal surgeon at our center who is specialized in abdominal wall surgery. Based on her specialty she developed a specific interest regarding (N)VRF and is currently working on a PhD thesis on this topic. She recently completed a systematic literature review, published in Transplantation Reviews (2021 Jun 4;35(4):100634). This review revealed that data on long-term outcome following NVRF regarding the strength and functionality of the abdominal wall is scarce.
Therefore we took the initiative for a multi-center survey on this topic to collect and analyze the world-wide practice and long-term outcome after (non-)vascularized fascia transplantation.
For this survey we have developed an excel sheet (1 excel file) and survey manual (PDF). We would be very grateful if you or one of your team members could have a look into this questionnaire and return your response directly to Nele (email@example.com) (1 sheet for each individual case).
It would be worth considering to publish in the near future the results of this multicenter survey if we can collect a sufficient number of cases performed worldwide. Participating centers would of course be granted a co-authorship.
Many thanks for your help and support. Please do not hesitate to contact us directly in case you have any further questions on this email.
Laurens Ceulemans (transplant surgeon)
Nele Van De Winkel (abdominal surgeon and PhD student)
On behalf of the Leuven LIFT team