Our Summary

This research paper focuses on intestine and intestine-liver transplants as treatments for intestinal failure. It notes that despite improvements in other treatments, these transplants remain crucial. The paper shows that in 2014, 210 new patients were added to the waiting list for these transplants. Of those already on the list, 65% were waiting for an intestine transplant and 35% for an intestine-liver transplant. The death rate before transplant has decreased significantly over time for all age groups, but is highest for adults waiting for transplants. The number of transplants performed increased in 2014. The main reason for needing these transplants was short-gut syndrome. The survival rate for patients after the transplant has improved over the past decade. However, survival rates vary, with adults receiving intestine-liver transplants having the lowest survival rate and children receiving intestine transplants having the highest.

FAQs

  1. What are the primary treatments for intestinal failure mentioned in the research paper?
  2. Are survival rates improving for patients who have undergone intestine and intestine-liver transplants?
  3. What is the main reason for needing an intestine or intestine-liver transplant as indicated in the paper?

Doctor’s Tip

One important tip a doctor might tell a patient about intestinal transplant is the importance of closely following post-transplant care instructions. This includes taking prescribed medications, attending follow-up appointments, maintaining a healthy diet, and avoiding certain foods or activities that may put the transplant at risk. It is also crucial to be aware of any signs of rejection or complications and to seek medical attention promptly if any concerns arise. By following these guidelines, patients can help ensure the success and longevity of their intestinal transplant.

Suitable For

Patients who are typically recommended for intestinal transplant include those with:

  • Intestinal failure, which can result from conditions such as short-gut syndrome, necrotizing enterocolitis, and intestinal atresia
  • Chronic intestinal pseudo-obstruction
  • Intestinal motility disorders
  • Intractable diarrhea
  • Intestinal ischemia
  • Intestinal tumors
  • Familial adenomatous polyposis
  • Crohn’s disease or ulcerative colitis that cannot be managed with medication or surgery

These patients may experience severe malnutrition, dehydration, electrolyte imbalances, and other complications that cannot be adequately managed with medical or surgical interventions. Intestinal transplant may be recommended when other treatments have failed to improve the patient’s quality of life or when the risks of complications from the underlying condition are high.

Timeline

Before intestinal transplant:

  • Patients with intestinal failure may undergo various treatments such as total parenteral nutrition (TPN) or small bowel transplantation.
  • Patients may experience complications such as infections, liver disease, and poor quality of life.
  • Patients are evaluated for transplant eligibility and added to the waiting list.
  • Patients wait for a suitable donor match.

After intestinal transplant:

  • Patients undergo the transplant surgery, which involves removing the damaged intestine and replacing it with a healthy donor intestine.
  • Patients are closely monitored in the hospital for complications such as rejection or infection.
  • Patients must take immunosuppressive medications for the rest of their lives to prevent rejection.
  • Patients undergo regular follow-up appointments and monitoring to assess the success of the transplant and manage any complications.
  • Patients may experience improvements in their quality of life and overall health.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with an intestinal transplant?
  2. How long is the waitlist for an intestinal transplant, and what factors determine priority for receiving a transplant?
  3. What is the success rate of intestinal transplants, and what factors can impact the outcome?
  4. What is the recovery process like after an intestinal transplant, and what kind of long-term care will be needed?
  5. Are there any alternative treatments or therapies that could be considered before proceeding with an intestinal transplant?
  6. How will medications be managed post-transplant, and what are the potential side effects?
  7. What lifestyle changes will be necessary after an intestinal transplant, such as diet and exercise?
  8. What kind of follow-up care and monitoring will be required after the transplant?
  9. How will the transplant impact my overall quality of life and ability to participate in daily activities?
  10. Are there any support groups or resources available for patients who have undergone an intestinal transplant?

Reference

Authors: Smith JM, Skeans MA, Horslen SP, Edwards EB, Harper AM, Snyder JJ, Israni AK, Kasiske BL. Journal: Am J Transplant. 2016 Jan;16 Suppl 2:99-114. doi: 10.1111/ajt.13669. PMID: 26755265