Our Summary

This research paper reviews the progress of intestinal transplants in Latin America and the Caribbean. These areas have varying economic and healthcare conditions, which affect how patients with intestinal failure are treated. Efforts to successfully perform intestinal transplants have been ongoing since 1968, but it wasn’t until 2004, with collaborative programs, that they began to see long-term success. Presently, Colombia, Argentina, and Brazil are the leading countries in the region performing these surgeries.

Since 2004, 135 intestinal transplants have been conducted, with Argentina performing the most (66) and Colombia following with 40. However, there is a lack of published research and adherence to existing medical registries. The future goals in this region include creating more all-inclusive medical units, increasing access to home parenteral nutrition (a form of feeding that bypasses the gastrointestinal tract), and fostering regional cooperation and networking. This will aid in achieving self-sufficiency and enhance long-term results in intestinal transplant procedures.

In simpler terms, this research is about how doctors in Latin America and the Caribbean have been getting better at performing intestine transplants over the years, but there’s still a lot of room for improvement, especially in terms of cooperation between countries and making sure everyone has access to the necessary care.

FAQs

  1. Which countries in Latin America and the Caribbean are currently performing intestinal transplants?
  2. How many intestinal transplants have been performed in Latin America and the Caribbean since 1968?
  3. What are the challenges faced in the development of intestinal transplant programs in Latin America and the Caribbean?

Doctor’s Tip

One important tip a doctor might give a patient undergoing an intestinal transplant is to closely follow post-operative care instructions, including medication regimens, dietary guidelines, and regular follow-up appointments. It is essential to communicate any changes or concerns to your healthcare team promptly in order to ensure the best outcomes and long-term success of the transplant.

Suitable For

Patients who are typically recommended for intestinal transplant are those with irreversible intestinal failure who are dependent on long-term parenteral nutrition, have complications related to parenteral nutrition such as liver disease, and have exhausted all other treatment options. These patients may have conditions such as short bowel syndrome, intestinal dysmotility, or chronic intestinal pseudo-obstruction. It is important for patients to be evaluated by a multidisciplinary team to determine if they are suitable candidates for an intestinal transplant.

Timeline

Before intestinal transplant:

  • Patient is diagnosed with intestinal failure, which can be caused by a variety of conditions such as short bowel syndrome, chronic intestinal pseudo-obstruction, or bowel ischemia.
  • Patient undergoes extensive medical management, including nutritional support through total parenteral nutrition (TPN) and treatment of underlying conditions.
  • Patient may experience complications such as infections, liver failure, and poor quality of life due to dependency on TPN.
  • Patient is evaluated for intestinal transplant candidacy, including assessment of overall health and psychological readiness for the procedure.
  • Patient is placed on the transplant waiting list, where they may wait for several months to years for a suitable donor organ to become available.

After intestinal transplant:

  • Patient undergoes the intestinal transplant surgery, which involves removing the diseased intestine and replacing it with a healthy donor intestine.
  • Patient is closely monitored in the intensive care unit and then on the transplant unit for post-operative complications such as rejection, infection, and organ dysfunction.
  • Patient undergoes extensive rehabilitation and physical therapy to regain strength and function post-surgery.
  • Patient is on lifelong immunosuppressive medications to prevent rejection of the transplanted organ.
  • Patient may experience complications related to the transplant, such as rejection episodes or infections, and require ongoing medical management.
  • Patient undergoes regular follow-up appointments with the transplant team to monitor for complications and adjust medications as needed.
  • Patient may experience improved quality of life, increased independence from TPN, and better overall health outcomes following successful intestinal transplant.

What to Ask Your Doctor

  1. How many intestinal transplants have you performed?
  2. What is your success rate with intestinal transplants?
  3. What are the potential risks and complications associated with an intestinal transplant?
  4. How long is the recovery period after an intestinal transplant?
  5. What is the long-term outlook for patients who undergo an intestinal transplant?
  6. How will I need to adjust my diet and lifestyle after an intestinal transplant?
  7. Will I need to take medication for the rest of my life after an intestinal transplant?
  8. How often will I need to follow up with you after the transplant?
  9. Are there any support groups or resources available for intestinal transplant patients in the region?
  10. Can you provide me with information on your experience and outcomes with intestinal transplants in Latin America and the Caribbean region?

Reference

Authors: Gondolesi GE, Doeyo M, Solar-Muñiz H. Journal: Curr Opin Organ Transplant. 2020 Apr;25(2):189-195. doi: 10.1097/MOT.0000000000000737. PMID: 32073496