Our Summary

This research paper discusses the complex procedures of intestinal transplantation and multivisceral transplantation. These operations are often the last resort for patients with severe, untreatable intestinal failure. More and more, these surgeries are involving other organs in addition to the small intestine. The article goes into detail about the common complex blood vessel reconstructions used in these procedures and how important understanding the surgical anatomy is for correctly interpreting post-surgery images. The paper goes over the reasons for these surgeries and the most common techniques used.

FAQs

  1. What are the common reasons for patients to undergo intestinal or multivisceral transplantation?
  2. How crucial is understanding surgical anatomy in interpreting post-surgery images in intestinal transplantation?
  3. What are the most common techniques used in intestinal and multivisceral transplantation surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal transplant is to closely follow post-operative care instructions to ensure the success of the transplant. This may include taking prescribed medications, attending follow-up appointments, and making lifestyle changes to support a healthy recovery. It is also important to communicate any changes or concerns with your medical team promptly.

Suitable For

Patients who are typically recommended for intestinal transplantation are those with severe intestinal failure that is unresponsive to other medical treatments, such as total parenteral nutrition (TPN) or bowel rehabilitation. Common indications for intestinal transplantation include short bowel syndrome, intestinal dysmotility disorders, chronic intestinal pseudo-obstruction, and intestinal ischemia.

In addition to intestinal failure, patients may also have other organ dysfunction that necessitates a multivisceral transplantation, which includes the small intestine along with the stomach, liver, pancreas, and sometimes the spleen. Patients with a history of multiple abdominal surgeries, severe malnutrition, recurrent sepsis, or liver dysfunction may also be candidates for intestinal transplantation.

Overall, patients who are recommended for intestinal transplantation are those who have exhausted all other treatment options and have a significantly decreased quality of life due to their intestinal failure. These surgeries are complex and carry significant risks, so careful patient selection and evaluation by a multidisciplinary team of specialists is essential in determining the appropriateness of intestinal transplantation for each individual patient.

Timeline

Before intestinal transplant:

  1. Patient is diagnosed with severe, untreatable intestinal failure.
  2. Patient undergoes extensive medical evaluations to determine if they are a candidate for transplantation.
  3. Patient is placed on a waiting list for a suitable donor organ.
  4. Patient undergoes pre-transplant medical interventions to prepare for surgery.

After intestinal transplant:

  1. Patient undergoes the complex surgical procedure of intestinal transplantation, which may also involve other organs.
  2. Patient is closely monitored in the intensive care unit post-surgery for complications.
  3. Patient undergoes a long recovery process, including rehabilitation and close monitoring for signs of organ rejection.
  4. Patient requires lifelong immunosuppressive medication to prevent rejection of the transplanted organ.
  5. Patient undergoes regular follow-up appointments and tests to monitor the success of the transplant and overall health.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with intestinal transplantation?
  2. How long is the recovery period after surgery and what is the expected outcome?
  3. What is the success rate of intestinal transplant surgery?
  4. How will I need to adjust my diet and lifestyle after the transplant?
  5. What are the long-term effects of taking immunosuppressive medications post-transplant?
  6. How often will I need to follow up with my transplant team after the surgery?
  7. Are there any alternative treatments or therapies that I should consider before pursuing intestinal transplant surgery?
  8. How experienced is the transplant team in performing intestinal transplant surgeries?
  9. What is the process for finding a suitable donor for the transplant?
  10. What support and resources are available for patients and their families before, during, and after the surgery?

Reference

Authors: Pugliesi RA, Dasyam AK, Borhani AA. Journal: Radiol Clin North Am. 2023 Sep;61(5):861-870. doi: 10.1016/j.rcl.2023.04.007. Epub 2023 May 16. PMID: 37495293