Our Summary

This research paper provides an overview of the state of intestinal transplants in Europe and the United States over the past five years. The study found that more such procedures are done in the United States than in Europe, with 634 and 222 transplants performed, respectively, from 2010 to 2014. The high number of deaths on the waiting list for these transplants is a major issue in both regions. The survival rate one year after a transplant has improved to over 80% at the busiest centers, thanks to new methods of matching donors and recipients and better organ allocation techniques. However, long-term outcomes are not as good as for other organ transplants. Most people who live a long time after their transplant are able to go back to work and support themselves. The cost of these transplants is high and varies between the United States and Europe, and even within Europe itself. The study concludes that more research is needed to prove that the benefits of intestinal transplants outweigh their high costs.

FAQs

  1. How many intestinal transplants were performed in the United States and Europe from 2010 to 2014?
  2. What factors have contributed to the improved survival rate one year after an intestinal transplant?
  3. What is the comparison of long-term outcomes of intestinal transplants to other organ transplants?

Doctor’s Tip

A doctor might tell a patient considering an intestinal transplant to carefully weigh the potential benefits and risks of the procedure. They may also advise the patient to seek out a reputable transplant center with a high success rate and to ask about the center’s experience with intestinal transplants specifically. Additionally, the doctor may recommend discussing the financial aspects of the transplant, including potential costs and insurance coverage, before making a decision. It is important for the patient to fully understand the process and potential outcomes of an intestinal transplant before moving forward.

Suitable For

Intestinal transplants are typically recommended for patients who have irreversible intestinal failure, which can be caused by a variety of conditions such as short bowel syndrome, motility disorders, chronic intestinal pseudo-obstruction, or complications from previous surgeries. Patients who have failed conventional treatments such as total parenteral nutrition (TPN) or who have experienced frequent complications such as infections, liver failure, or poor quality of life may be considered for an intestinal transplant. Additionally, patients who have a high risk of mortality while on the waiting list for a transplant, such as those with severe liver disease or recurrent central line infections, may also be recommended for an intestinal transplant.

Timeline

Before an intestinal transplant, a patient typically experiences severe complications from intestinal failure, such as malnutrition, dehydration, and frequent infections. They may have tried various treatments and therapies to manage their condition, but have not had success in improving their quality of life. The patient would undergo a series of evaluations and tests to determine their eligibility for a transplant, including psychological assessments, blood tests, imaging scans, and consultations with a transplant team.

After an intestinal transplant, the patient would initially stay in the hospital for several weeks to monitor for any signs of rejection or complications. They would require intensive medical care, including medications to suppress the immune system and prevent rejection of the new organ. The patient would need to follow a strict regimen of medications, regular follow-up appointments, and lifestyle changes to ensure the success of the transplant. Over time, the patient would gradually regain their strength and ability to eat and digest food normally, leading to improvements in their overall health and quality of life.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with an intestinal transplant?

  2. How long is the recovery process after an intestinal transplant?

  3. What kind of follow-up care will be needed after the transplant?

  4. What medications will I need to take after the transplant, and what are the potential side effects?

  5. How will the transplant impact my diet and nutrition?

  6. What are the long-term outcomes and success rates for intestinal transplants?

  7. How will the transplant impact my quality of life?

  8. What is the financial cost of an intestinal transplant, and what kind of insurance coverage is available?

  9. How do I find a qualified transplant center for this procedure?

  10. Are there any alternative treatments or therapies that I should consider before proceeding with an intestinal transplant?

Reference

Authors: Lauro A, Panaro F, Iyer KR. Journal: J Visc Surg. 2017 Apr;154(2):105-114. doi: 10.1016/j.jviscsurg.2017.01.007. Epub 2017 Apr 21. PMID: 28434656