Our Summary

This research paper is a review of how multi-organ transplantation (MVT) has developed over the past 60 years. It highlights how improvements in surgery techniques and medicine to suppress the immune system have made MVT a useful and practical approach to treatment. The review also shows how the use of MVT has expanded to include various combinations of organs and techniques. Thanks to advances in nutrition, transplant results, and surgical innovation, more patients can benefit from this type of transplant, offering hope to those with complex digestive system disorders. The paper also discusses developments in how we preserve organs for transplant and the ways we assess the success of a transplant, which have led to better patient outcomes.

FAQs

  1. What developments have made multi-organ transplantation a practical approach to treatment?
  2. How have advances in nutrition, transplant results, and surgical innovation expanded the use of multi-organ transplantation?
  3. What improvements have been made in the preservation of organs for transplant and the assessment of transplant success?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal transplant is to closely follow their post-transplant medications and treatment plan. This may include taking immunosuppressant medications to prevent rejection of the transplanted intestine, as well as regular follow-up appointments with healthcare providers to monitor progress and address any potential complications. It’s also important for patients to follow a healthy diet and lifestyle to support the success of the transplant.

Suitable For

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

  1. Short bowel syndrome: A condition where the small intestine is not functioning properly, leading to malabsorption of nutrients and fluids. This can be caused by conditions such as Crohn’s disease, ischemic bowel disease, or trauma.

  2. Intestinal failure: When the intestines are unable to absorb enough nutrients to sustain the body’s needs, leading to chronic malnutrition and dehydration.

  3. Chronic intestinal pseudo-obstruction: A rare condition where the intestines are unable to contract and move food through the digestive system, leading to symptoms similar to a bowel obstruction.

  4. Intestinal tumors: Patients with tumors in the intestines that cannot be surgically removed may require an intestinal transplant.

  5. Inflammatory bowel disease: Severe cases of Crohn’s disease or ulcerative colitis that do not respond to medical treatment may require an intestinal transplant.

  6. Motility disorders: Conditions such as gastroparesis or chronic intestinal dysmotility that affect the movement of food through the digestive system may benefit from an intestinal transplant.

  7. Failed previous intestinal transplant: Patients who have had a previous intestinal transplant that has failed may be candidates for a re-transplant.

Overall, patients who are experiencing severe complications from their digestive system disorders and have exhausted other treatment options may be recommended for an intestinal transplant. It is important for patients to undergo a thorough evaluation by a transplant team to determine if they are suitable candidates for the procedure.

Timeline

Before an intestinal transplant:

  • Patient is diagnosed with a severe digestive disorder or intestinal failure that cannot be managed with other treatments
  • Patient undergoes extensive testing and evaluation to determine if they are a suitable candidate for a transplant
  • Patient is placed on a waiting list for a suitable donor intestine
  • Patient may require a temporary treatment such as total parenteral nutrition (TPN) to maintain nutrition and hydration while waiting for a transplant

After an intestinal transplant:

  • Patient undergoes a complex surgery to remove the diseased intestine and replace it with a healthy donor intestine
  • Patient is closely monitored in the intensive care unit (ICU) for several days following the transplant
  • Patient begins a regimen of immunosuppressive medications to prevent organ rejection
  • Patient undergoes regular follow-up appointments and monitoring to assess the success of the transplant and manage any complications
  • Patient may experience complications such as infection, rejection, or side effects from immunosuppressive medications
  • Patient gradually resumes normal activities and diet as their body adjusts to the new intestine
  • Patient may require ongoing medical care and monitoring for the rest of their life to ensure the long-term success of the transplant.

What to Ask Your Doctor

  1. What are the risks and benefits of an intestinal transplant for my specific condition?
  2. How long is the recovery process and what can I expect in terms of post-transplant care?
  3. What are the potential complications after an intestinal transplant and how are they managed?
  4. How will the transplant affect my quality of life and long-term outcomes?
  5. What is the success rate of intestinal transplants at this hospital or transplant center?
  6. How will the transplant affect my ability to eat and digest food?
  7. What medications will I need to take after the transplant and what are the potential side effects?
  8. How often will I need to follow up with my transplant team after the procedure?
  9. Are there any lifestyle changes or dietary restrictions I need to follow after the transplant?
  10. What support services are available for transplant recipients, such as counseling or support groups?

Reference

Authors: Abreu P, Manzi J, Vianna R. Journal: Curr Opin Organ Transplant. 2024 Feb 1;29(1):88-96. doi: 10.1097/MOT.0000000000001098. Epub 2023 Oct 30. PMID: 37902277