Our Summary

This study looks at how to improve the chances of success for patients receiving an intestinal transplant. Some people have high levels of antibodies that can attack the new organ, making the transplant risky. To manage this, the researchers use a virtual method to estimate the risk of each potential donor-recipient match before deciding to go ahead with the transplant. They also discuss a new technique to reduce the presence of these harmful antibodies in the patient before surgery. After the transplant, they monitor and treat any new harmful antibodies that form. The researchers are also working on new criteria for diagnosing when the body is rejecting the new organ. All these methods have helped to improve the success rate of intestinal transplants.

FAQs

  1. How can high levels of antibodies affect the success of an intestinal transplant?
  2. What methods are researchers using to improve the success rate of intestinal transplants?
  3. What is the new technique being used to reduce the presence of harmful antibodies in patients before surgery?

Doctor’s Tip

Overall, the key takeaway is that it’s important to work closely with your medical team and follow their recommendations before, during, and after an intestinal transplant to maximize the chances of a successful outcome. Remember to communicate any changes or concerns with your healthcare providers promptly to ensure the best possible care.

Suitable For

Patients who are typically recommended for intestinal transplants are those with severe intestinal failure or dysfunction that cannot be managed effectively with other treatments such as medications, diet modifications, or tube feeding. Common reasons for intestinal transplants include short bowel syndrome, intestinal pseudo-obstruction, chronic intestinal pseudo-obstruction, and certain types of inflammatory bowel disease.

Patients who may benefit from an intestinal transplant are those who have:

  • Chronic and severe malnutrition
  • Frequent episodes of dehydration and electrolyte imbalances
  • Recurrent infections related to intestinal dysfunction
  • Failure to thrive and inability to gain weight
  • Dependence on total parenteral nutrition (TPN) for long periods of time
  • Complications from TPN such as liver failure or infections
  • Intestinal failure associated with other medical conditions such as cancer, vascular disorders, or trauma

It is important for patients being considered for an intestinal transplant to undergo a thorough evaluation by a multidisciplinary team of specialists including transplant surgeons, gastroenterologists, nutritionists, social workers, and psychologists to determine if they are suitable candidates for the procedure. The decision to undergo an intestinal transplant is not taken lightly and is typically reserved for patients who have exhausted all other treatment options and have a high risk of complications or death without the transplant.

Timeline

Before Intestinal Transplant:

  1. Patient is diagnosed with intestinal failure and is referred to a transplant center.
  2. Patient undergoes extensive evaluation to determine if they are a suitable candidate for a transplant.
  3. Patient is placed on the waiting list for a donor organ.
  4. Patient may undergo pre-transplant treatments to manage their condition and prepare for surgery.

After Intestinal Transplant:

  1. Patient undergoes surgery to receive the new intestine.
  2. Patient is closely monitored in the intensive care unit post-surgery.
  3. Patient may experience complications such as rejection of the new organ or infections.
  4. Patient undergoes regular follow-up appointments and tests to monitor the success of the transplant.
  5. Patient may need to take immunosuppressant medication for the rest of their life to prevent rejection.
  6. Patient gradually resumes normal activities and diet, with ongoing support from a multidisciplinary medical team.

What to Ask Your Doctor

  1. What is the success rate of intestinal transplants?
  2. How will my risk of rejection be assessed before the transplant?
  3. What techniques are used to reduce harmful antibodies in the body before surgery?
  4. How will new harmful antibodies be monitored and treated after the transplant?
  5. What criteria are used to diagnose rejection of the new organ?
  6. What are the potential complications or side effects of an intestinal transplant?
  7. How long is the recovery process after an intestinal transplant?
  8. What lifestyle changes will I need to make after the transplant?
  9. How often will I need to follow up with the transplant team after the surgery?
  10. Are there any support groups or resources available for intestinal transplant recipients?

Reference

Authors: Matsumoto CS, Rosen-Bronson S. Journal: Curr Opin Organ Transplant. 2021 Apr 1;26(2):245-249. doi: 10.1097/MOT.0000000000000853. PMID: 33528224