Our Summary

The research paper discusses intestinal transplantation, which is the only effective treatment for severe chronic intestinal failure, according to guidelines from the German Medical Chamber. This procedure, however, is only considered after all other methods of intestinal rehabilitation have been exhausted due to the complex challenges it presents, including immune response, surgical complications, and infection risks.

The paper reviews international literature and guidelines, including those of the German Medical Chamber, providing an overview of the different types of intestinal transplants, which are customized based on the specific needs of each patient and their associated health conditions.

Approximately 100-150 intestinal transplants are performed globally each year, with survival rates of nearly 80% after one year and 70% after three years. This makes it the least common of all organ transplants that involve blood vessels.

FAQs

  1. What is the only effective treatment for severe chronic intestinal failure according to the German Medical Chamber?
  2. How many intestinal transplants are performed globally each year and what is the survival rate?
  3. When is an intestinal transplant considered as a treatment option for patients with severe chronic intestinal failure?

Doctor’s Tip

A doctor may tell a patient considering an intestinal transplant to ensure they have exhausted all other options for treatment of severe chronic intestinal failure before considering this procedure. It is important to understand the complex challenges and risks involved, including potential complications with the immune system, surgery, and infections. The patient should be informed about the different types of intestinal transplants available and how they can be customized to meet their specific needs and health conditions. It is also important to discuss the survival rates associated with intestinal transplants and to have a clear understanding of what to expect post-transplant.

Suitable For

Patients who are typically recommended for intestinal transplant are those with severe chronic intestinal failure that cannot be managed with other treatments such as parenteral nutrition, bowel lengthening procedures, or small bowel transplantation. These patients may suffer from conditions such as short bowel syndrome, motility disorders, or vascular complications.

In addition, patients who have complications from long-term parenteral nutrition, such as liver failure or recurrent infections, may also be candidates for intestinal transplant. It is important for patients to have a thorough evaluation by a multidisciplinary team, including gastroenterologists, transplant surgeons, nutritionists, and psychologists, to determine if they are suitable candidates for the procedure.

Overall, intestinal transplant is recommended for patients who have exhausted all other treatment options and have a poor quality of life due to their chronic intestinal failure. The procedure can provide these patients with a chance for improved quality of life and long-term survival.

Timeline

Before the intestinal transplant:

  • Patient undergoes extensive evaluation to determine if they are a suitable candidate for the procedure
  • Patient is placed on a waiting list for a suitable donor organ
  • Patient may need to undergo pre-transplant treatments to prepare their body for the surgery
  • Patient may experience complications and symptoms related to their intestinal failure, such as malnutrition, dehydration, and infections

After the intestinal transplant:

  • Patient undergoes the transplant surgery, which can take several hours and involves connecting the donor intestine to the patient’s digestive system
  • Patient is closely monitored in the intensive care unit post-surgery to manage any complications and ensure the new organ is functioning properly
  • Patient may need to take immunosuppressant medications for the rest of their life to prevent rejection of the transplanted organ
  • Patient undergoes regular follow-up appointments and tests to monitor the success of the transplant and address any potential complications

Overall, the process of intestinal transplantation is complex and requires ongoing care and monitoring to ensure the best possible outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about intestinal transplant include:

  1. Am I a candidate for intestinal transplant surgery?
  2. What are the risks and potential complications of an intestinal transplant?
  3. How long is the recovery process after an intestinal transplant?
  4. What medications will I need to take after the transplant to prevent rejection?
  5. How will the transplant impact my daily life and activities?
  6. What are the long-term outcomes and success rates of intestinal transplant surgery?
  7. Are there any alternative treatments or therapies that I can consider before opting for a transplant?
  8. How will the transplant team monitor and follow up with me post-surgery?
  9. Are there any dietary or lifestyle changes I need to make following the transplant?
  10. What support services are available for patients undergoing intestinal transplant surgery?

Reference

Authors: Pascher A. Journal: Zentralbl Chir. 2025 Jun;150(3):209-212. doi: 10.1055/a-2568-8965. Epub 2025 Apr 24. PMID: 40273926