Our Summary

The number of people receiving intestinal transplants is increasing, and this presents unique challenges for the doctors who look after them. Improvements in patient and transplant survival rates are mainly due to advances in surgery, better anti-rejection treatments, and improved monitoring methods that can detect rejection and other complications more accurately. This paper discusses the methods used at the University of Illinois Hospital to manage and treat transplant patients who experience complications such as acute rejection, lack of blood supply, bleeding, abnormal connections, a type of cancer that can develop after a transplant, and slow stomach emptying. More research is needed to develop and refine treatments for these complications to improve the survival and function of the transplanted intestine.

FAQs

  1. What advancements have contributed to the improvement in patient and graft survival in intestinal transplant recipients?
  2. What complications can arise in patients who have undergone an intestinal transplant?
  3. What are the current research directions in the field of intestinal transplants?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal transplant is to closely follow the prescribed medication regimen to prevent rejection of the transplanted intestine. It is important to take medications as directed and attend all follow-up appointments to monitor for any signs of rejection or complications. Additionally, maintaining a healthy diet and lifestyle can help support the success of the transplant.

Suitable For

Patients who are typically recommended for intestinal transplant are those with irreversible intestinal failure who are dependent on parenteral nutrition due to conditions such as short bowel syndrome, motility disorders, or chronic intestinal pseudo-obstruction. These patients may have complications such as frequent infections, liver failure, or poor venous access for parenteral nutrition. Additionally, patients with complications from previous abdominal surgeries, such as severe adhesions or strictures, may also be candidates for intestinal transplant. It is important for patients to have good overall health and be able to tolerate the rigorous post-transplant care and immunosuppressive therapy required for successful outcomes.

Timeline

Before Intestinal Transplant:

  • Patient is diagnosed with a severe intestinal disorder that cannot be managed with traditional treatments
  • Patient undergoes extensive evaluations and testing to determine if they are a suitable candidate for a transplant
  • Patient is placed on the waiting list for a suitable donor organ
  • Patient receives pre-transplant care and counseling to prepare for the surgery

After Intestinal Transplant:

  • Patient undergoes the surgical procedure to receive the new intestine
  • Patient is closely monitored in the intensive care unit post-surgery for any complications
  • Patient undergoes regular follow-up appointments with their transplant team to monitor the success of the transplant and adjust medications as needed
  • Patient may experience complications such as acute rejection, infection, or graft versus host disease, which require further treatment and management
  • Patient may need to make lifestyle changes and adhere to a strict medication regimen to prevent rejection and maintain the health of the new organ
  • Patient may experience improvements in their overall health and quality of life as a result of the successful transplant.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with an intestinal transplant?
  2. How long is the recovery process after an intestinal transplant?
  3. What type of medications will I need to take post-transplant and what are the potential side effects?
  4. How often will I need to undergo follow-up appointments and tests to monitor the success of the transplant?
  5. What lifestyle changes will I need to make after the transplant to maintain the health of the new intestine?
  6. What are the signs and symptoms of rejection or other complications that I should be aware of?
  7. Are there any dietary restrictions or guidelines I should follow after the transplant?
  8. How successful are intestinal transplants in general, and what is the long-term prognosis for transplant recipients?
  9. Are there any support groups or resources available for intestinal transplant recipients?
  10. What research or advancements are currently being made in the field of intestinal transplants that may benefit me in the future?

Reference

Authors: Carroll RE. Journal: Gastroenterol Clin North Am. 2018 Jun;47(2):381-391. doi: 10.1016/j.gtc.2018.01.012. PMID: 29735031