Our Summary

This research paper discusses the challenges related to the treatment of Intestinal Failure (IF), a serious health condition that threatens lives all over the world. The quality and type of medical care available for IF vary greatly, and many regions face issues in accessing the necessary treatments, making managing IF particularly challenging. These issues are especially pronounced in developing countries. The paper provides updated information about IF, including definitions, global data, and recent advancements. It also discusses treatment options in Latin America, the Middle East, and Asia, in order to illustrate possible solutions for helping patients with IF in underserved countries.

FAQs

  1. What is intestinal failure and why is it considered a life-threatening condition?
  2. How does the quality and type of medical care vary globally for intestinal failure patients?
  3. What are the different access alternatives for intestinal transplant in Latin America, Middle East, and Asia?

Doctor’s Tip

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

Suitable For

Patients who are typically recommended for intestinal transplant are those with intestinal failure, which may be caused by a variety of conditions such as short bowel syndrome, chronic intestinal pseudo-obstruction, or severe inflammatory bowel disease. These patients are unable to absorb nutrients properly and may require long-term parenteral nutrition or intravenous feeding. Intestinal transplant may be considered for patients who have not had success with other treatments, such as bowel lengthening surgeries or bowel rehabilitation programs. Transplant may also be recommended for patients who are at high risk of complications from long-term parenteral nutrition, such as liver failure or infections. In general, patients who are considered for intestinal transplant are those who have a high risk of mortality or morbidity from their underlying intestinal failure.

Timeline

Before intestinal transplant:

  1. Intestinal failure diagnosis: Patients with intestinal failure are unable to maintain adequate nutrition and hydration through the oral route, leading to the need for parenteral nutrition.

  2. Medical management: Patients with intestinal failure require long-term intravenous nutrition and close monitoring for complications such as liver disease and infections.

  3. Evaluation for transplant: Patients with severe intestinal failure who have exhausted all other treatment options may be evaluated for intestinal transplant as a last resort.

After intestinal transplant:

  1. Surgery: Patients undergo a complex surgical procedure to remove the damaged intestine and replace it with a healthy donor intestine.

  2. Recovery: Patients require intensive post-operative care in the hospital to monitor for complications such as rejection and infection.

  3. Long-term management: Patients require lifelong immunosuppressive medications to prevent rejection of the transplanted intestine and regular follow-up appointments to monitor for complications.

  4. Improved quality of life: With a successful intestinal transplant, patients can resume normal eating and drinking, and may experience improved overall health and quality of life.

What to Ask Your Doctor

  1. What is an intestinal transplant and how does it work?
  2. Am I a candidate for an intestinal transplant?
  3. What are the potential risks and complications associated with an intestinal transplant?
  4. How long is the recovery process after an intestinal transplant?
  5. What is the success rate of intestinal transplants?
  6. What are the long-term effects of an intestinal transplant?
  7. How will I need to adjust my lifestyle after receiving an intestinal transplant?
  8. What is the availability of intestinal transplant programs in my area?
  9. What are the costs associated with an intestinal transplant and will my insurance cover it?
  10. Are there any alternative treatments or therapies that I should consider before pursuing an intestinal transplant?

Reference

Authors: Gondolesi GE, Nikoupour H, Matsumoto CS. Journal: Gastroenterol Clin North Am. 2024 Sep;53(3):509-519. doi: 10.1016/j.gtc.2024.04.001. Epub 2024 May 9. PMID: 39068011