Our Summary

This research paper discusses intestinal transplantation, a procedure that is considered for patients suffering from severe complications of long-term intestinal failure or diseases affecting the digestive system. The type of transplant a patient receives depends on various factors, including the presence of other organ failures, the availability of donor organs, and the type of specialized care needed. Combining a liver and intestinal transplant can offer patients with liver disease related to parenteral nutrition (nutrition delivered through the bloodstream) a better chance at improved health, nutrition, and overall survival. Over the past few decades, intestinal transplantation has greatly advanced, and the survival rate of patients who receive these transplants is now on par with those receiving other types of solid organ transplants.

FAQs

  1. Who are the potential candidates for intestinal transplantation?
  2. What factors influence the choice of the allograft for intestinal transplantation?
  3. How does combined liver and intestinal transplant improve the quality of life for patients with parenteral nutrition-associated liver disease?

Doctor’s Tip

A helpful tip a doctor might give a patient about intestinal transplant is to follow all post-transplant care instructions closely, including taking medications as prescribed, attending follow-up appointments, and maintaining a healthy lifestyle to support the success of the transplant. It’s important to communicate any changes or concerns to your healthcare team promptly to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for intestinal transplant are those with life-threatening complications of permanent intestinal failure or underlying gastrointestinal disease. This includes patients who have parenteral nutrition-associated liver disease, as a combined liver and intestinal transplant can improve their quality of life, nutrition, and survival. The choice of the allograft for a particular patient depends on factors such as the presence of concurrent organ failure, availability of donor organs, and specialized care. Intestinal transplantation has advanced significantly in recent decades, with current graft survivals comparable to other solid organ transplants.

Timeline

Before Intestinal Transplant:

  1. Patient is diagnosed with life-threatening complications of permanent intestinal failure or underlying gastrointestinal disease.
  2. Patient undergoes various treatments and therapies to manage symptoms and maintain nutrition, including parenteral nutrition.
  3. Patient may experience complications such as liver disease due to long-term parenteral nutrition.
  4. Patient is evaluated by a transplant team to determine if they are a candidate for intestinal transplantation.
  5. Patient is placed on the transplant waiting list and awaits a suitable donor organ.

After Intestinal Transplant:

  1. Patient undergoes intestinal transplant surgery, which may include a combined liver and intestinal transplant depending on their condition.
  2. Patient is monitored closely in the hospital for any complications or rejection of the transplant.
  3. Patient undergoes rehabilitation and post-transplant care to ensure proper healing and recovery.
  4. Patient may need to take immunosuppressive medications for the rest of their life to prevent rejection of the transplant.
  5. Patient undergoes regular follow-up appointments and monitoring to assess the function of the transplanted organ and overall health.
  6. Patient experiences improved quality of life, nutrition, and survival compared to before the transplant.

What to Ask Your Doctor

  1. Am I a candidate for intestinal transplant?
  2. What are the risks and benefits of intestinal transplant for my specific condition?
  3. How long is the recovery process and what can I expect post-transplant?
  4. What is the success rate of intestinal transplants in patients with my condition?
  5. Are there any alternative treatments or therapies that I should consider before undergoing a transplant?
  6. What is the long-term outlook for patients who undergo intestinal transplant?
  7. How often will I need to follow up with my transplant team after the procedure?
  8. Are there any lifestyle changes or dietary restrictions I will need to adhere to post-transplant?
  9. What is the availability of donor organs for intestinal transplants?
  10. Are there any clinical trials or research studies related to intestinal transplantation that I should be aware of?

Reference

Authors: Kahn AB, Tulla KA, Tzvetanov IG. Journal: Gastroenterol Clin North Am. 2019 Dec;48(4):575-583. doi: 10.1016/j.gtc.2019.08.010. Epub 2019 Oct 4. PMID: 31668184