Our Summary

This research paper discusses a surgical method first introduced in 1997 for transplanting intestines from a living donor. The technique involves taking a portion of the small intestine (ileum) from the donor, while leaving enough behind to maintain important bodily functions. The transplanted intestine is then attached to the recipient’s major blood vessels and the rest of their digestive tract.

This method is a game-changer because it allows transplants to be scheduled, rather than waiting for a deceased donor, which can be unpredictable. It’s especially useful for patients with severe, but potentially reversible, liver disease caused by long-term use of intravenous feeding (total parenteral nutrition or TPN). It can even be used for combined liver and intestine transplants.

The paper notes that this technique is safe for the donor, with no major complications or deaths reported. Some donors even show improved metabolism after the procedure. Since the introduction of this technique, 85 successful transplants have been performed in over 20 different medical centers in 12 countries, with about 70 using the standard method. The results are comparable to transplants using intestines from deceased donors, with some transplants functioning well for over 10 years.

In conclusion, this method of intestine transplantation from a living donor has gone from experimental to an established and standard procedure.

FAQs

  1. What does the surgical method introduced in 1997 for intestinal transplant involve?
  2. Why is this method of intestinal transplant considered a game-changer?
  3. How safe is this technique for the donor and how successful has it been since its introduction?

Doctor’s Tip

One helpful tip a doctor might tell a patient considering an intestinal transplant is to discuss the option of a living donor transplant with their medical team. This method can offer a faster and more predictable transplant timeline, as well as potentially better outcomes for certain patients. It’s important for the patient to fully understand the risks and benefits of this procedure and to have open communication with their healthcare providers throughout the process.

Suitable For

Patients who are typically recommended for intestinal transplant include those with severe liver disease due to long-term use of intravenous feeding, as well as those in need of combined liver and intestine transplants. These patients may have complications such as liver failure or malnutrition that can be potentially reversed with a successful transplant. Additionally, patients who have failed conventional treatments for intestinal failure, such as TPN, may also be candidates for intestinal transplant. Overall, this surgical method offers a promising treatment option for patients with complex intestinal and liver disorders.

Timeline

Timeline of a patient’s experience before and after intestinal transplant:

Before transplant:

  • Patient diagnosed with severe intestinal failure requiring a transplant
  • Patient undergoes thorough evaluation and testing to determine eligibility for transplant
  • Patient is placed on the transplant waiting list and waits for a suitable donor
  • Patient may experience complications from their condition, such as malnutrition, dehydration, and infections
  • Patient may require intravenous feeding (TPN) to sustain them until a transplant is available

After transplant:

  • Patient undergoes the transplant surgery, which involves removing diseased intestine and replacing it with healthy intestine from a living donor
  • Patient is closely monitored in the intensive care unit post-surgery for any complications
  • Patient begins the recovery process, which includes physical therapy, dietary adjustments, and medication management
  • Patient may experience complications such as rejection of the transplanted organ, infections, or side effects from medications
  • Patient undergoes regular follow-up appointments and monitoring to ensure the success of the transplant
  • Over time, patient may experience improved quality of life, increased energy levels, and reduced dependence on medical interventions

Overall, the process of intestinal transplant can be a challenging and complex journey for patients, but it offers hope for those with severe intestinal failure to regain their health and quality of life.

What to Ask Your Doctor

  1. How long does the recovery process typically take for the recipient after an intestinal transplant?

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

  3. How long do transplanted intestines typically last in the recipient’s body?

  4. What medications will I need to take after the transplant to prevent rejection of the new intestine?

  5. How often will I need to follow up with my healthcare team after the transplant surgery?

  6. Are there any dietary restrictions or changes I will need to make post-transplant?

  7. How will the transplant surgery impact my overall quality of life?

  8. Are there any long-term side effects or complications I should be aware of after receiving an intestinal transplant?

  9. How do I know if my body is rejecting the transplanted intestine?

  10. Are there any additional support services or resources available for intestinal transplant recipients?

Reference

Authors: Gruessner RWG. Journal: Transplant Proc. 2022 Sep;54(7):1944-1953. doi: 10.1016/j.transproceed.2022.05.022. Epub 2022 Aug 4. PMID: 35933238