Our Summary

This research paper looks at the role of intestine transplants in treating intestinal failure. Despite advancements in medical and surgical treatments, intestine transplants are still crucial. However, the number of people being added to the waiting list for such transplants has been decreasing over the last ten years, hitting a low of 135 in 2018. The number of intestine donors and transplants performed has also decreased, with 104 transplants performed in 2018, and almost 60% of these were intestine-liver transplants. There hasn’t been much change in the number of transplants failing over the last decade. Survival rates for patients vary depending on their age and the type of transplant. Adult patients who received an intestine-liver transplant had the lowest survival rates, while children who received an intestine transplant had the highest.

FAQs

  1. Has the number of patients added to the intestine transplant waiting list decreased in recent years?
  2. What is the survival rate for adult intestine-liver transplant recipients?
  3. How does the patient survival rate vary between pediatric and adult intestine transplant recipients?

Doctor’s Tip

A doctor might tell a patient considering an intestinal transplant to carefully follow their post-transplant medication regimen to prevent rejection and ensure the best possible outcomes. They may also advise the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support their overall health and the success of the transplant. Finally, the doctor may emphasize the importance of attending regular follow-up appointments and communicating any concerns or changes in symptoms promptly to their healthcare team.

Suitable For

Patients who are typically recommended for intestinal transplant are those with intestinal failure who have not responded to other treatments, such as parenteral nutrition or surgical procedures. These patients may have conditions such as short bowel syndrome, intestinal ischemia, or motility disorders. Patients who have complications from long-term parenteral nutrition, such as liver failure, may also be candidates for an intestine-liver transplant. Additionally, pediatric patients with congenital intestinal disorders or severe intestinal dysmotility may be recommended for an intestinal transplant. Patients who are evaluated for an intestinal transplant must meet specific criteria and undergo a thorough evaluation process to determine their eligibility for the procedure.

Timeline

Before intestinal transplant:

  • Patient experiences symptoms of intestinal failure, such as severe diarrhea, weight loss, malnutrition, and dehydration.
  • Patient undergoes extensive medical evaluations and tests to determine the cause and severity of their intestinal failure.
  • Patient is placed on a waiting list for an intestine transplant, as this is often a last resort treatment option.
  • Patient may require parenteral nutrition (nutrition delivered through a vein) to sustain their health while waiting for a transplant.

After intestinal transplant:

  • Patient undergoes a complex surgical procedure to replace their diseased intestine with a healthy donor intestine.
  • Patient is closely monitored in the hospital for complications such as infection, rejection, and organ failure.
  • Patient requires lifelong immunosuppressive medications to prevent rejection of the transplanted intestine.
  • Patient undergoes regular follow-up appointments with their transplant team to monitor their health and the function of the transplanted intestine.
  • Patient may experience improvements in their quality of life, such as reduced symptoms of intestinal failure and improved nutrition absorption.

What to Ask Your Doctor

  1. What are the risks and benefits of an intestinal transplant for my specific condition?
  2. What is the success rate of intestinal transplants at your facility?
  3. How long is the typical recovery time after an intestinal transplant?
  4. What kind of follow-up care will I need after the transplant?
  5. What are the potential complications or side effects of an intestinal transplant?
  6. How will I need to adjust my lifestyle or diet after the transplant?
  7. What is the average wait time for an intestinal transplant?
  8. Are there any alternative treatments or therapies that I should consider before opting for a transplant?
  9. How frequently will I need to visit the transplant center for check-ups and monitoring?
  10. Are there any support groups or resources available for intestinal transplant patients?

Reference

Authors: Smith JM, Weaver T, Skeans MA, Horslen SP, Miller E, Noreen SM, Snyder JJ, Israni AK, Kasiske BL. Journal: Am J Transplant. 2020 Jan;20 Suppl s1:300-339. doi: 10.1111/ajt.15675. PMID: 31898410