Our Summary

The number of adult intestine transplants done in the U.S. has been dropping since 2008, reaching its lowest point in 2019. This study looks at why this might be happening. The reasons could include better methods of rehabilitating the intestine, which reduces the need for transplants. Also, there have been changes in key staff and there aren’t many experts in this very specialized field, which could also be leading to fewer transplants. The study suggests that there are probably multiple reasons for the drop in transplants. It also suggests that the guidelines for when an intestine transplant is needed, provided by the Centers for Medicare and Medicaid Services, might be outdated and need to be updated.

FAQs

  1. Why has the number of adult intestine transplants been decreasing in the U.S. since 2008?
  2. What are some of the factors that might be causing fewer intestine transplants?
  3. Does the study suggest that the guidelines for when an intestine transplant is needed might need to be updated?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal transplant is to follow a strict medication regimen and attend regular follow-up appointments to monitor for any signs of rejection or complications. It is important to maintain a healthy lifestyle, including a balanced diet and regular exercise, to support the success of the transplant. Additionally, it is important to communicate openly with your healthcare team about any concerns or changes in your health to ensure the best possible outcome.

Suitable For

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

  1. Short bowel syndrome: This condition occurs when a significant portion of the small intestine is missing or non-functional, leading to malabsorption of nutrients and fluids.

  2. Intestinal failure: This condition occurs when the intestines are unable to digest or absorb nutrients properly, often leading to dependence on parenteral nutrition (intravenous feeding).

  3. Chronic intestinal pseudo-obstruction: This condition is characterized by symptoms similar to a bowel obstruction, but without a physical blockage. It can result in severe abdominal pain, bloating, and constipation.

  4. Intestinal dysmotility disorders: These conditions involve abnormalities in the movement of the intestines, leading to symptoms such as chronic constipation or diarrhea.

  5. Intestinal tumors: In some cases, patients with malignant tumors in the intestines may require an intestinal transplant as part of their treatment plan.

Overall, patients recommended for intestinal transplant are those who have severe intestinal dysfunction that cannot be effectively managed with other medical treatments or therapies. These patients may experience significant complications related to their condition, such as malnutrition, dehydration, and organ failure, making a transplant their best option for improved quality of life and long-term survival.

Timeline

Before an intestinal transplant, a patient typically undergoes a series of evaluations to determine if they are a suitable candidate for the procedure. This may include medical tests, psychological evaluations, and consultations with a transplant team. Once deemed eligible, the patient is placed on a waiting list for a suitable donor organ.

After receiving an intestinal transplant, the patient will need to stay in the hospital for a period of time to monitor for any complications and ensure the success of the transplant. They will need to take immunosuppressant medications for the rest of their life to prevent rejection of the new organ. The patient will also require ongoing medical follow-up, including regular check-ups and monitoring for any signs of rejection or other complications.

Overall, the process of before and after an intestinal transplant can be lengthy and complex, requiring significant commitment from both the patient and their medical team.

What to Ask Your Doctor

  1. How many intestinal transplants have you performed in the past year?

  2. What are the potential risks and complications associated with an intestinal transplant?

  3. What is the success rate of intestinal transplants at your facility?

  4. How long is the recovery process after an intestinal transplant?

  5. What type of follow-up care will be needed after the transplant?

  6. Are there any alternative treatment options to an intestinal transplant that I should consider?

  7. What criteria do you use to determine if a patient is a candidate for an intestinal transplant?

  8. Are there any specific lifestyle changes I will need to make after the transplant?

  9. How long is the waiting time for a suitable donor intestine?

  10. Are there any clinical trials or new advancements in intestinal transplant surgery that I should be aware of?

Reference

Authors: Iyer K, Moon J. Journal: Curr Opin Organ Transplant. 2020 Apr;25(2):196-200. doi: 10.1097/MOT.0000000000000748. PMID: 32142482