Introduction: Nutritional management after intestinal transplant is very important part of transplant, but post-operative diets vary depending on countries because they are based on cultural background. Rice based diet (so called Japanese food) is usually used after post-operative treatment in Japan. We introduced rice based post-operative diet and assess its safety and efficiency.

Methods: Patients who received isolated intestinal transplant in our institution were reviewed. All patients received rice based post-operative diet after intestinal transplant. Tacrolimus based immunosuppressions were administrated intravenously then orally. Diet starting date, advancing, parental nutrition off and outcome were assessed.

Results: Three patients were received rice based diet after intestinal transplant. Age at transplant was median 17 year olds. (Ranged 14 year olds to 32 year olds) Original diseases were congenital microvillous atrophy, Hirschsprung's allied disease and short gut syndrome. Types of donor were living donor (n=1) and cadaveric donor (n=2). Induction therapies were Daclizumab (n=1) and rabbit anti thymus globulin (n=2). Everolimus was added at one month after intestinal transplant for two patients. Intestinal graft length was median 160cm (150-260cm). Two patients had enteral feeding tube. All patients started rice based post-operative diet as rice gruel (Omoyu) at post-operative day (POD) 26 (ranged POD 7 to POD49) orally. Diet was advanced to rice gruel in three degree (rice: water=1:20), five degree (rice: water=1:10) and regular (rice: water=1:5). Diet reached regular gruel at mean POD 45 (ranged POD18 to POD87). Side dish started later avoiding protein oral intake. Patients are free from parental nutrition at median POD119 (ranged POD 22 to 209). Longer graft tend to leave parental nutrition early. Parental nutrition could be terminate with regular diet for patient with long graft. All patients survived longer than 3 months. There was no complication according to race based post-operative diet.

Conclusion: Rice based post-operative diet after intestinal transplant was safe after intestinal transplant. Rice based post-operative diet had great advantages its form and less protein. Softness of gruel were easily controlled with rice water ratio. Polished rice has less protein. The contents of side dish were need to be further evaluation.