Our Summary

This paper discusses irreversible intestinal failure, a serious condition that can greatly impact a person’s health and quality of life. This condition can be treated with an intestinal transplant, which can involve just the intestine, or the intestine and liver, or other internal organs.

People who are candidates for an intestinal transplant often have widespread health issues related to their intestinal failure. Therefore, they need a thorough assessment at a specialist transplant center. One concern is that accessing the central part of the body may be difficult in these patients.

The transplant operation itself is complicated and can cause changes in blood flow and metabolism in the body. While the success rates for patients and transplants are getting better, the most common problem after surgery is graft failure, where the body rejects the new organ.

FAQs

  1. What conditions may qualify a patient for an intestinal transplant?
  2. What are the potential complications of an intestinal transplant?
  3. What is the survival rate for patients and grafts following an intestinal transplant?

Doctor’s Tip

A doctor may tell a patient undergoing an intestinal transplant to follow a strict medication regimen, adhere to a specific diet plan, and attend regular follow-up appointments to monitor the health of the transplanted intestine. They may also advise the patient to avoid contact with individuals who are sick and to practice good hygiene to prevent infections. Additionally, it is important for the patient to communicate any changes in symptoms or concerns to their healthcare team promptly.

Suitable For

Patients who are typically recommended for intestinal transplant include those with irreversible intestinal failure, often due to conditions such as short bowel syndrome, chronic intestinal pseudo-obstruction, or severe inflammatory bowel disease. These patients may have failed conventional medical and surgical treatments for their condition and may be dependent on parenteral nutrition for sustenance. They may also have complications such as liver failure or recurrent infections related to their intestinal failure.

Patients being considered for intestinal transplant undergo a thorough evaluation by a multidisciplinary team at an intestinal transplantation center to assess their candidacy for the procedure. This evaluation takes into account the patient’s overall health, nutritional status, psychosocial support, and ability to adhere to post-transplant care requirements.

Intestinal transplantation is a complex and high-risk procedure, and patients must be carefully selected to maximize the chances of a successful outcome. Patients who are deemed suitable candidates for intestinal transplant may undergo either intestine-only transplant or a multivisceral transplant, which includes the liver and other abdominal organs in addition to the intestine.

Overall, intestinal transplantation offers hope for improved quality of life and survival for patients with irreversible intestinal failure who have exhausted other treatment options. Ongoing research and advancements in the field of intestinal transplantation continue to improve outcomes for these patients.

Timeline

Before Intestinal Transplant:

  • Patients with irreversible intestinal failure experience significant morbidity, mortality, and decreased quality of life.
  • Candidates for intestinal transplantation present with systemic manifestations of intestinal failure and undergo multidisciplinary evaluation at an intestinal transplantation center.
  • Central access may be difficult to obtain in these patients.
  • The decision for intestinal transplantation is made based on the severity of the patient’s condition and their potential for recovery.

After Intestinal Transplant:

  • Intestinal transplantation is a complex operation with potential for hemodynamic and metabolic instability.
  • Patient and graft survival rates are improving, but graft failure remains a common postoperative complication.
  • Patients undergo a period of recovery and rehabilitation post-transplant, including close monitoring for signs of rejection or complications.
  • Long-term follow-up care is necessary to ensure the success of the transplant and the overall health of the patient.

What to Ask Your Doctor

  1. What are the risks and benefits of intestinal transplantation for my specific case?
  2. How long is the recovery process and what can I expect during the recovery period?
  3. What is the success rate of intestinal transplantation and what factors can affect the success of the transplant?
  4. How will I need to modify my lifestyle or diet post-transplantation?
  5. What medications will I need to take after the transplant and what are the potential side effects?
  6. How often will I need to follow up with my healthcare team after the transplant?
  7. What signs or symptoms should I watch for that may indicate rejection or other complications?
  8. How will the transplant impact my overall health and quality of life in the long term?
  9. Are there any alternative treatments or options available for my condition aside from transplantation?
  10. How experienced is the transplant team in performing intestinal transplants and what is their success rate?

Reference

Authors: Nguyen-Buckley C, Wong M. Journal: Anesthesiol Clin. 2017 Sep;35(3):509-521. doi: 10.1016/j.anclin.2017.04.007. Epub 2017 Jul 5. PMID: 28784223