Our Summary

This research paper looks at the risk of viral infections in the gut (enteritis) in people who have had an intestine transplant. These individuals are more susceptible to infections because their immune systems are suppressed to prevent their bodies from rejecting the transplanted organ. The study analyzed data from transplanted patients between 2008 and 2016 and found that almost 44% of them had contracted some form of viral enteritis. The most common viruses were norovirus and adenovirus, followed by rotavirus and sapovirus. Children who had had an intestine transplant were more likely to contract viral enteritis than adults, with 58% of pediatric patients affected compared to just 10% of adult patients. Most patients recovered from the infection within a week, and standard treatments included anti-motion sickness drugs, drugs to curb vomiting, and intravenous hydration.

FAQs

  1. What is the risk of viral infections in patients who have had an intestine transplant?
  2. Which viruses are most common in patients who have had an intestine transplant?
  3. What treatments are used for patients who contract viral enteritis after an intestine transplant?

Doctor’s Tip

A doctor might advise a patient who has had an intestinal transplant to practice good hygiene, such as washing hands frequently and avoiding close contact with sick individuals, to reduce the risk of viral enteritis. It is also important for patients to follow their medication regimen as prescribed to maintain a healthy immune system and prevent infections. Regular follow-up appointments with their medical team are crucial to monitor for any signs of infection and adjust treatment if necessary.

Suitable For

Intestinal transplants are typically recommended for patients who suffer from severe intestinal failure or dysfunction that cannot be managed with other forms of treatment. Common reasons for needing an intestinal transplant include:

  • Short bowel syndrome: This is a condition in which a significant portion of the small intestine has been removed or is not functioning properly, leading to malabsorption of nutrients and fluids.
  • Chronic intestinal pseudo-obstruction: This condition causes symptoms similar to a bowel obstruction, but without a physical blockage. It can lead to severe abdominal pain, bloating, and vomiting.
  • Intestinal motility disorders: These disorders affect the movement of the intestines, leading to problems with digestion and absorption of nutrients.
  • Inflammatory bowel disease: Severe cases of Crohn’s disease or ulcerative colitis that do not respond to medical treatment may require an intestinal transplant.
  • Intestinal tumors or other structural abnormalities: In some cases, tumors or other abnormalities in the intestines may necessitate a transplant.

Patients who are considering an intestinal transplant should undergo a thorough evaluation by a transplant team to determine if they are suitable candidates for the procedure. This evaluation will assess the patient’s overall health, the severity of their intestinal condition, and their ability to withstand the rigors of transplant surgery and post-transplant care.

Timeline

Before intestinal transplant:

  • Patient is diagnosed with a severe gastrointestinal disorder that is not responding to other treatments
  • Patient undergoes extensive testing and evaluation to determine if they are a candidate for an intestine transplant
  • Patient is placed on the transplant waiting list and waits for a suitable donor match
  • Patient may experience worsening symptoms, malnutrition, and complications from their condition

After intestinal transplant:

  • Patient undergoes the transplant surgery, which can last several hours
  • Patient is closely monitored in the intensive care unit for any signs of rejection or complications
  • Patient is started on immunosuppressive medications to prevent rejection of the transplanted organ
  • Patient undergoes frequent follow-up appointments and monitoring to ensure the transplant is successful
  • Patient may experience complications such as infections, rejection episodes, and side effects from medications
  • Patient may need to make significant lifestyle changes, including dietary restrictions and regular medication management
  • Patient gradually recovers and improves their quality of life, with the goal of achieving normal gastrointestinal function and overall health.

What to Ask Your Doctor

  1. What are the common types of viral infections that can occur after an intestinal transplant?
  2. How can I reduce my risk of contracting viral enteritis after the transplant?
  3. What symptoms should I look out for that may indicate a viral infection in my gut?
  4. How will my immune system be affected by the medications I need to take to prevent rejection of the transplanted organ?
  5. What are the treatment options available if I do contract a viral infection in my gut after the transplant?
  6. Are there any specific precautions I should take to prevent spreading the infection to others?
  7. How often should I be monitored for potential viral infections after the transplant?
  8. Are there any long-term effects of viral enteritis on my overall health and the success of the transplant?
  9. Are there any vaccines or other preventative measures I should consider to protect myself from viral infections post-transplant?
  10. What support resources are available to help me manage any viral infections that may occur after the transplant?

Reference

Authors: Servais AM, Keck M, Leick M, Mercer DF, Langnas AN, Grant WJ, Vargas LM, Merani S, Florescu DF. Journal: Transpl Infect Dis. 2020 Apr;22(2):e13248. doi: 10.1111/tid.13248. Epub 2020 Jan 29. PMID: 31960531