Our Summary

This study examined the success rates of combined intestine and kidney transplants. Out of 2215 intestinal transplants done from 2000 to 2015, about 5% were combined with a kidney transplant. Almost half of the people who received the combined transplant died even though their new kidney was still functional. The survival rates for the transplanted kidneys were 57% after one year, 39% after three years, and 34% after five years. However, if the patient survived the first year, the kidney survival rates improved to 93% after one year, 90% after three years, and 86% after five years. Patient survival was generally lower for those who had the combined transplant compared to those who only had an intestinal transplant. The findings suggest that the success of the kidney transplant largely depends on whether the patient survives the first year. This information should be considered when deciding who should receive a kidney transplant.

FAQs

  1. What was the survival rate for the kidneys after a combined intestine and kidney transplant?
  2. How does the survival rate of a patient with a combined transplant compare to those who only had an intestinal transplant?
  3. How does the survival rate of the kidney transplant change if the patient survives the first year post-transplant?

Doctor’s Tip

It is important to closely monitor your kidney function after an intestinal transplant, as the success of the kidney transplant is closely tied to your overall survival. Make sure to follow up with your transplant team regularly and report any changes in your kidney function promptly. Additionally, taking good care of your overall health, including managing any underlying conditions like diabetes or high blood pressure, can help improve the success of your transplant.

Suitable For

Patients who are typically recommended for intestinal transplant include those with severe intestinal failure, such as those with short bowel syndrome, intestinal motility disorders, or chronic intestinal pseudo-obstruction. These patients may have difficulty absorbing nutrients and fluids, leading to malnutrition, dehydration, and electrolyte imbalances. Intestinal transplant may be considered when other treatments, such as total parenteral nutrition, have not been successful in managing their condition.

Patients with complications from previous abdominal surgeries, such as bowel obstructions or adhesions, may also be candidates for intestinal transplant. Additionally, patients with intestinal diseases such as Crohn’s disease, ulcerative colitis, or intestinal ischemia may be recommended for transplant if their condition is severe and not responding to other treatments.

Patients who require a combined intestinal and kidney transplant may have additional complications, such as kidney failure due to long-term total parenteral nutrition or complications from their underlying intestinal disease. These patients may have a higher risk of mortality compared to those who only require an intestinal transplant, but the success of the kidney transplant may improve if the patient survives the first year post-transplant.

Overall, the decision to recommend an intestinal transplant, either alone or combined with a kidney transplant, is based on the individual patient’s medical history, severity of their condition, and potential benefits and risks of the transplant procedure.

Timeline

Before an intestinal transplant, a patient may have been suffering from a severe intestinal disorder or failure that has not responded to other treatments. They may have been experiencing symptoms such as malnutrition, dehydration, weight loss, diarrhea, and abdominal pain. The patient would undergo extensive testing and evaluation to determine if they are a suitable candidate for a transplant.

After the intestinal transplant, the patient would need to stay in the hospital for a period of time to monitor for any complications and ensure the new organ is functioning properly. They would need to take immunosuppressant medications to prevent rejection of the new organ, and would require regular follow-up appointments with their transplant team to monitor their progress.

Over time, the patient would need to adjust to their new diet and lifestyle to maintain the health of their transplanted intestine. They may experience complications such as infection, rejection, or side effects from the immunosuppressant medications. With proper care and monitoring, the patient can experience improved quality of life and function with their new intestine.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with an intestinal transplant?
  2. How long is the recovery process after an intestinal transplant?
  3. What is the success rate of intestinal transplants at this facility?
  4. How long does a transplanted intestine typically last?
  5. Are there any specific dietary or lifestyle changes I will need to make after the transplant?
  6. What is the likelihood of needing a combined kidney transplant with the intestinal transplant?
  7. What are the success rates of combined intestinal and kidney transplants?
  8. How will the medications needed after the transplant affect my overall health and immune system?
  9. What is the long-term outlook for patients who receive an intestinal transplant?
  10. Are there any alternative treatments or therapies that I should consider before pursuing an intestinal transplant?

Reference

Authors: Moinuddin I, Yaqub MS, Taber T, Mujtaba M, Sharfuddin A. Journal: Clin Transplant. 2018 Apr;32(4):e13213. doi: 10.1111/ctr.13213. Epub 2018 Feb 16. PMID: 29377289