Our Summary

This research paper looks at how often infections occur in the stomach or bloodstream after patients have had a transplant involving the intestines or multiple organs. By reviewing medical records from 2003 to 2015, the researchers found that out of 103 patients who had these types of transplants, 43% of them ended up with an infection in their stomach. Some even had infections in both their stomach and bloodstream. These infections typically showed up around 23 days after the operation. The study also found that the infections were caused by a variety of bacteria, including some that are resistant to antibiotics. Despite this, patients with infections didn’t spend significantly longer in the hospital than those without infections, and having an infection didn’t increase their chance of dying. This suggests that while these infections are common after these types of transplants, they don’t necessarily have a big impact on the patient’s overall health or survival.

FAQs

  1. What percentage of patients developed infections in their stomach after having an intestinal or multiple organ transplant?
  2. How soon after the operation do these infections typically appear?
  3. Does having an infection after an intestinal or multiple organ transplant increase the patient’s chance of dying or lengthen their hospital stay?

Doctor’s Tip

A doctor might tell a patient undergoing an intestinal transplant to be vigilant about signs of infection, such as fever, abdominal pain, or changes in bowel movements, and to seek medical attention promptly if any of these symptoms occur. They may also advise the patient to practice good hygiene, follow a healthy diet, and take prescribed medications as directed to help prevent infections and promote healing after the transplant. Additionally, the doctor may emphasize the importance of regular follow-up appointments and monitoring for any potential complications.

Suitable For

Intestinal transplants are typically recommended for patients who have severe intestinal failure that cannot be managed with other treatments such as parenteral nutrition or surgery. Some common reasons for intestinal transplant include:

  1. Short bowel syndrome: This condition occurs when a significant portion of the small intestine is missing or nonfunctional, leading to malabsorption of nutrients and fluids.

  2. Chronic intestinal pseudo-obstruction: This condition is characterized by symptoms of intestinal obstruction without any physical blockage, leading to severe abdominal pain, bloating, and vomiting.

  3. Intestinal motility disorders: Conditions such as gastroparesis or chronic intestinal dysmotility can lead to severe gastrointestinal symptoms and malnutrition.

  4. Intestinal ischemia: This condition occurs when blood flow to the intestines is compromised, leading to tissue damage and potential organ failure.

  5. Chronic inflammatory bowel disease: Patients with severe Crohn’s disease or ulcerative colitis that cannot be managed with medications may be candidates for intestinal transplant.

  6. Intestinal tumors or other malignancies: In some cases, patients with tumors or other cancers affecting the intestines may require a transplant as part of their treatment plan.

Overall, intestinal transplants are considered a last resort option for patients with severe intestinal failure who have not responded to other treatments. These patients often have a significantly reduced quality of life and may be at risk for complications such as infections, organ rejection, and long-term complications related to immunosuppressive medications.

Timeline

Before intestinal transplant:

  1. Patient undergoes extensive evaluation to determine if they are a suitable candidate for an intestinal transplant.
  2. Patient is placed on a waiting list for a donor intestine.
  3. Patient may experience complications from their underlying intestinal disease, such as malnutrition or dehydration.
  4. Patient may undergo pre-transplant medical treatments to optimize their health before the transplant.

After intestinal transplant:

  1. Patient undergoes surgery to receive the donor intestine.
  2. Patient is closely monitored in the hospital for complications such as infection, rejection, or organ failure.
  3. Patient may require intensive medical treatment to manage complications and ensure the success of the transplant.
  4. Patient undergoes long-term follow-up care to monitor for signs of rejection or other complications.
  5. Patient may need to take immunosuppressant medications for the rest of their life to prevent rejection of the transplanted intestine.
  6. Patient may experience improvements in their overall health and quality of life as a result of the transplant.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with intestinal transplant surgery?
  2. How common are infections in the stomach or bloodstream following an intestinal transplant?
  3. What steps can be taken to prevent infections after the transplant surgery?
  4. How are infections typically treated in patients who have had an intestinal transplant?
  5. What signs and symptoms should I watch for that may indicate an infection after the transplant?
  6. How often will I need to follow up with my healthcare team after the transplant surgery?
  7. Are there any specific dietary or lifestyle changes I should make to support my recovery and reduce the risk of infections?
  8. What is the long-term outlook for patients who have had an intestinal transplant, particularly in relation to infections and overall health?

Reference

Authors: Spence AB, Natarajan M, Fogleman S, Biswas R, Girlanda R, Timpone J. Journal: Transpl Infect Dis. 2020 Feb;22(1):e13219. doi: 10.1111/tid.13219. Epub 2019 Dec 13. PMID: 31778012