Our Summary

This research paper is about intestinal transplantation, which is a treatment for patients with intestinal failure. The paper discusses the latest trends and practices in this field and compares them to a different treatment method called intestinal rehabilitation. The researchers found that the timing for when a patient is referred for this transplant and the care they receive before and after the surgery are very important for the transplant to be as successful as possible. They also found that intestinal transplantation is getting better and could be a good option for patients who are currently on permanent home parenteral nutrition (a method of getting nutrition into the body through the veins). The key to the best long-term results is to manage the timing of the referral and the care before and after the surgery.

FAQs

  1. What is the purpose of an intestinal transplantation?
  2. How have preoperative and postoperative care advanced for intestinal and multivisceral transplant candidates?
  3. How does the timing of referral affect the results of an intestinal transplant?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal transplant is to closely follow postoperative care instructions, including taking prescribed medications, attending follow-up appointments, and maintaining a healthy lifestyle to optimize long-term results. It is also important to communicate any changes or concerns to your healthcare team promptly.

Suitable For

Patients who are typically recommended for intestinal transplant are those with intestinal failure who are unable to achieve adequate nutrition through oral intake or enteral feeding, and who require long-term parenteral nutrition. These patients may have conditions such as short bowel syndrome, intestinal motility disorders, or chronic intestinal pseudo-obstruction. Patients who have complications from long-term parenteral nutrition, such as liver failure or recurrent infections, may also be candidates for intestinal transplant. Timing for referral to an intestinal transplant center is important, as early referral can optimize outcomes and improve long-term results. Additionally, advances in preoperative and postoperative care have helped to improve overall outcomes for intestinal transplant recipients.

Timeline

Before Intestinal Transplant:

  1. Patient is diagnosed with intestinal failure and begins treatment with parenteral nutrition.
  2. Patient undergoes evaluation to determine if they are a candidate for intestinal transplant.
  3. Patient is placed on the waiting list for a suitable donor organ.
  4. Patient undergoes pre-transplant evaluations and tests to assess their overall health and suitability for transplant surgery.

After Intestinal Transplant:

  1. Patient undergoes the transplant surgery, which involves removing the diseased intestine and replacing it with a healthy donor organ.
  2. Patient is closely monitored in the intensive care unit post-surgery for any complications.
  3. Patient undergoes a period of recovery in the hospital, where they receive postoperative care and monitoring.
  4. Patient is discharged from the hospital and continues to receive follow-up care and monitoring to ensure the success of the transplant.
  5. Patient may need to take immunosuppressive medications for the rest of their life to prevent rejection of the donor organ.
  6. Patient undergoes rehabilitation and nutritional support to help them adjust to their new intestinal function.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing 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 hospital or transplant center?
  4. How will my quality of life be impacted after an intestinal transplant?
  5. What kind of long-term follow-up care will be necessary after the transplant?
  6. Are there any alternative treatments or therapies that I should consider before opting for an intestinal transplant?
  7. What is the likelihood of rejection or complications following an intestinal transplant?
  8. How experienced is the medical team at this hospital or transplant center in performing intestinal transplants?
  9. What support services are available for patients and their families before, during, and after the transplant procedure?
  10. What are the eligibility criteria for being considered a candidate for an intestinal transplant?

Reference

Authors: Garcia J, Selvaggi G, Tekin A, Vianna R. Journal: Curr Opin Organ Transplant. 2021 Apr 1;26(2):229-233. doi: 10.1097/MOT.0000000000000865. PMID: 33651002