Our Summary

The International Intestinal Transplant Registry (ITR) collects data from around the world to help us understand more about the results of intestinal transplants. This study looked at the data of children who had these transplants from 1985 to 2017. Over 2000 children received intestine transplants during this period. The study found that survival rates and successful transplant rates were best for children who were having their first transplant and those who also had a liver transplant. The success of the transplant was also higher when the child was healthy enough to choose when to have the transplant rather than being rushed into it while in hospital. The ability to eat and drink normally without needing extra support after the transplant has been getting better over time. Problems with the body rejecting the new intestine are the main reason for the transplant not lasting in the long term. A second transplant is less likely to be successful, and serious infections are the main cause of death in these children. The ITR is now gathering more information about the donors, how well matched the donor and recipient are, and the development of new antibodies after the transplant.

FAQs

  1. What is the International Intestinal Transplant Registry and what is its purpose?
  2. What factors contribute to the success of an intestinal transplant in children?
  3. What are the main challenges or complications that can occur after an intestinal transplant in children?

Doctor’s Tip

It’s important to be aware of the potential risks and complications associated with intestinal transplant, and to follow your doctor’s instructions closely to improve your chances of a successful outcome. Make sure to discuss any concerns or questions you have with your healthcare team, and keep them informed of any changes in your health or symptoms. Additionally, maintaining a healthy lifestyle and following post-transplant care guidelines can help support the function of your new intestine and improve your overall well-being.

Suitable For

Intestinal transplants are typically recommended for patients who have irreversible intestinal failure and are unable to absorb nutrients and fluids properly, leading to severe malnutrition and complications. Some common reasons for intestinal transplant recommendation include:

  1. Short bowel syndrome: This is the most common indication for intestinal transplant, where a significant portion of the small intestine is missing or non-functional, leading to malabsorption of nutrients.

  2. Chronic intestinal pseudo-obstruction: This condition causes severe intestinal motility issues, leading to symptoms similar to a bowel obstruction.

  3. Intestinal failure due to inflammatory bowel disease: Patients with severe Crohn’s disease or ulcerative colitis may develop intestinal failure that requires a transplant.

  4. Intestinal ischemia: Reduced blood flow to the intestines can lead to tissue damage and intestinal failure, necessitating a transplant.

  5. Intestinal tumors or other rare conditions: Some patients may require an intestinal transplant due to rare conditions such as intestinal tumors or congenital abnormalities.

Overall, intestinal transplants are considered for patients who have exhausted all other treatment options and have a high risk of complications or death without a transplant. The decision to recommend an intestinal transplant is made by a multidisciplinary team of healthcare providers, including transplant surgeons, gastroenterologists, and nutritionists, based on the specific needs and condition of the patient.

Timeline

Before an intestinal transplant, a patient may experience severe intestinal failure, leading to dependence on parenteral nutrition and a reduced quality of life. The patient may also have complications such as infections, liver failure, and growth failure.

After an intestinal transplant, the patient undergoes a period of recovery in the hospital, where they are closely monitored for signs of rejection and other complications. They will need to take immunosuppressive medications for the rest of their life to prevent rejection of the new organ. Over time, the patient may experience improved nutrition and quality of life, as they are able to eat and drink normally without the need for parenteral nutrition. However, they may still face challenges such as the risk of rejection, infections, and the development of new antibodies. Long-term success of the transplant depends on factors such as the health of the patient, the match between the donor and recipient, and the presence of any complications.

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 and what kind of follow-up care will be necessary?
  3. How will the success of the transplant be monitored and evaluated over time?
  4. What medications will I need to take after the transplant and what are the potential side effects?
  5. How will the transplant affect my diet and nutritional needs?
  6. What lifestyle changes or restrictions will I need to follow after the transplant?
  7. How long do intestinal transplants typically last and what factors can impact the longevity of the transplant?
  8. What are the chances of rejection and what symptoms should I watch out for?
  9. What is the experience and success rate of the transplant center with intestinal transplants?
  10. Are there any alternative treatment options or clinical trials that I should consider?

Reference

Authors: Raghu VK, Beaumont JL, Everly MJ, Venick RS, Lacaille F, Mazariegos GV. Journal: Pediatr Transplant. 2019 Dec;23(8):e13580. doi: 10.1111/petr.13580. Epub 2019 Sep 18. PMID: 31531934