Our Summary

This research paper discusses a procedure called abdominal wall transplantation, which is used to close the abdomen after certain types of organ transplants. The research explores whether the skin used in this process can also act as a tool to monitor the body’s immune response. Recent findings suggest that the skin can show signs of early rejection, such as developing a rash, which can help doctors start treatment before the body significantly rejects the transplanted organs. This could also be helpful in cases where it’s unclear why the intestines aren’t functioning properly, such as during an infection. Even though the added skin comes from a donor and could potentially increase the body’s immune response, it doesn’t seem to require additional immune-suppressing treatment. In summary, several medical centers have shown that abdominal wall transplantation is both technically and immunologically possible. Using the transplanted skin as an early warning system for organ rejection could improve the survival of the transplanted organs and decrease the negative effects of immune-suppressing treatments.

FAQs

  1. What is abdominal wall transplantation?
  2. How can the skin used in abdominal wall transplantation act as a tool to monitor the body’s immune response?
  3. Does the added skin from a donor in abdominal wall transplantation require additional immune-suppressing treatment?

Doctor’s Tip

A doctor might advise a patient undergoing an intestinal transplant to be vigilant about monitoring their skin for any signs of rash or other skin changes, as this could be an early indicator of rejection. By keeping a close eye on their skin, the patient can help their medical team intervene early and potentially prevent serious complications. Additionally, the patient should continue to follow their prescribed medication regimen and attend regular check-ups to ensure the success of the transplant.

Suitable For

Intestinal transplant patients are typically recommended for patients who have irreversible intestinal failure, which can be caused by a variety of factors such as congenital abnormalities, inflammatory bowel disease, or complications from previous surgeries. These patients often require long-term total parenteral nutrition (TPN) to receive the necessary nutrients, but this can lead to complications such as liver failure or infections.

Patients who have failed other treatments for intestinal failure, such as bowel lengthening procedures or intestinal rehabilitation programs, may also be considered for intestinal transplant. Additionally, patients who have experienced severe complications from TPN, such as recurrent central line infections or liver failure, may be recommended for transplant.

Overall, intestinal transplant is considered a treatment of last resort for patients with irreversible intestinal failure who have failed other treatments. It is a complex procedure with significant risks, but for some patients, it can provide a chance at a better quality of life and improved long-term outcomes.

Timeline

  • Before intestinal transplant: Patients with intestinal failure may experience symptoms such as severe diarrhea, weight loss, malnutrition, and dependence on intravenous nutrition. They may undergo various tests and treatments to manage their condition, but ultimately require an intestinal transplant to improve their quality of life and survival.

  • Intestinal transplant surgery: The patient undergoes a complex surgical procedure to remove the diseased intestine and replace it with a healthy donor intestine. This surgery may take several hours and require a team of skilled surgeons, anesthesiologists, and nurses.

  • Recovery: After the transplant surgery, the patient is closely monitored in the intensive care unit for any complications or signs of rejection. They may experience side effects from the surgery and require pain management, physical therapy, and rehabilitation to regain strength and function.

  • Immune suppression: To prevent rejection of the transplanted intestine, the patient must take immunosuppressive medications for the rest of their life. These medications help to suppress the body’s immune response and reduce the risk of rejection, but also increase the risk of infection and other complications.

  • Follow-up care: Patients who undergo intestinal transplant require lifelong follow-up care to monitor the function of their transplanted intestine, manage complications, adjust medications, and address any new health concerns. They may need regular blood tests, imaging studies, and clinic visits to ensure the long-term success of the transplant.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with intestinal transplantation?
  2. How long is the recovery process after the surgery?
  3. What kind of follow-up care will be needed after the transplant?
  4. How will the transplanted intestine function compared to my original intestine?
  5. What lifestyle changes will I need to make after the transplant?
  6. How will the transplant impact my immune system and what medications will I need to take?
  7. What are the success rates of intestinal transplantation?
  8. How long do transplanted intestines typically last?
  9. Are there any alternative treatments or options to consider before undergoing an intestinal transplant?
  10. How will the transplant impact my overall health and quality of life in the long term?

Reference

Authors: Barnes J, Issa F, Vrakas G, Friend P, Giele H. Journal: Curr Opin Organ Transplant. 2016 Oct;21(5):536-40. doi: 10.1097/MOT.0000000000000352. PMID: 27495916