Our Summary

This research paper discusses a method used in multi-organ transplants, which typically involve the transplant of the stomach, pancreas, intestine, and liver together. In this process, the patient’s spleen is usually removed to create more space in the abdomen for the new organs. This results in the patient being without a spleen after the transplant. The authors suggest that temporarily transplanting the donor’s spleen could be a better option. This could help lower the chances of the patient’s body rejecting the new intestine, without increasing the risk of the transplanted organs attacking the host body (a condition known as graft-versus-host disease).

FAQs

  1. What organs are typically involved in a multi-organ transplant?
  2. Why is the patient’s spleen usually removed during the process of multi-organ transplant?
  3. How could temporarily transplanting the donor’s spleen potentially benefit the patient after a multi-organ transplant?

Doctor’s Tip

A doctor might tell a patient undergoing an intestinal transplant to follow a strict medication regimen to prevent rejection of the new organ. It is also important for the patient to maintain a healthy lifestyle, including a balanced diet and regular exercise, to support the success of the transplant. Additionally, the patient should closely monitor any signs of infection or rejection and report them to their healthcare provider immediately. Regular follow-up appointments with the transplant team are essential for long-term success.

Suitable For

Patients who are typically recommended for an intestinal transplant are those with severe intestinal failure who have not responded to other treatments, such as total parenteral nutrition (TPN) or bowel rehabilitation. These patients may have conditions such as short bowel syndrome, intestinal pseudo-obstruction, or inflammatory bowel disease that have led to significant malnutrition, dehydration, and other complications.

Intestinal transplant may also be recommended for patients who have complications from previous surgeries, such as bowel obstructions, strictures, or fistulas, that cannot be effectively managed with conservative treatments.

In some cases, intestinal transplant may be considered for patients with functional disorders of the intestine, such as chronic intestinal dysmotility or chronic intestinal pseudo-obstruction, that have not responded to other treatments.

Overall, patients who are in good overall health and have a strong support system are typically considered for intestinal transplant. Transplant centers will evaluate each patient individually to determine if they are a suitable candidate for the procedure.

Timeline

Before the intestinal transplant:

  1. Patient is diagnosed with a severe intestinal disorder or disease that requires a transplant.
  2. Patient undergoes extensive medical evaluations and testing to determine if they are a suitable candidate for a transplant.
  3. Patient is placed on a waiting list for a donor intestine, which can take months or even years.
  4. Patient may experience severe symptoms and complications from their intestinal disorder, requiring frequent hospitalizations and medical interventions.

After the intestinal transplant:

  1. Patient undergoes the transplant surgery, which can last several hours and involves the removal of the diseased intestine and the placement of the donor intestine.
  2. Patient is closely monitored in the intensive care unit post-surgery for any complications or signs of rejection.
  3. Patient may experience side effects from the immunosuppressive medications used to prevent rejection of the new intestine.
  4. Patient undergoes extensive rehabilitation and recovery to regain strength and function after the transplant.
  5. Patient requires lifelong follow-up care and monitoring to ensure the success of the transplant and manage any potential complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with an intestinal transplant?

  2. How long is the recovery process after an intestinal transplant and what is the expected outcome?

  3. What kind of follow-up care will be needed after the transplant?

  4. How will medication management be handled post-transplant?

  5. What are the chances of rejection of the transplanted intestine and how is this monitored?

  6. What lifestyle changes will be necessary after an intestinal transplant?

  7. Are there any dietary restrictions or special considerations that need to be taken into account post-transplant?

  8. How will the transplant impact my overall health and well-being in the long term?

  9. What support services are available for patients undergoing an intestinal transplant?

  10. How often will I need to follow up with my medical team after the transplant?

Reference

Authors: Matsumoto R, Kato T. Journal: Gastroenterol Clin North Am. 2024 Jun;53(2):281-288. doi: 10.1016/j.gtc.2023.12.002. Epub 2024 Mar 19. PMID: 38719378