What is an Intestine Transplant?

Intestine transplantation (also known as intestinal transplantation or small bowel transplantation) is a surgical procedure that replaces the small intestine in patients with chronic or acute intestinal failure.

The human body requires nutrition to function properly. If they can’t be consumed owing to intestinal failure, they’re given intravenously by complete parenteral nutrition, which involves placing a catheter in the patient’s neck, arm, chest, or groin. Because using a catheter for an extended time increases the risk of infections, bone dislocation, and liver illness, an intestinal transplant becomes the only long-term treatment for intestinal failure.

Intestinal failure can occur at any time after birth or later in life. In the following situations, an intestinal transplant may be required:

• Short gut syndrome
• TPN (Total Parenteral Nutrition) complications are a common occurrence. These include the failure to locate additional intact veins into which the catheter can be inserted, bone movement caused by prolonged insertion, and infection.
• Complications of the liver

Intestinal failure can be caused by a variety of factors, including nutritional, viral, traumatic, and metabolic problems that impair normal anatomy and physiology.

The inability to absorb nutrients, fluids, and electrolytes from food, which happens in case of small intestine failure can be life-threatening. Homeostasis cannot be maintained without these vital substances and so would be the ability to maintain energy balances without the small intestine working.

Types of Intestinal Transplant

Small bowel transplant: Only the small intestine is transplanted

Combined intestine and liver transplant: In addition to a small bowel transplant, you may have a liver transplant also.

Multivisceral transplant: A multivisceral transplant often includes a pancreas transplant. Some people also receive a stomach or colon transplant.

Modified multivisceral transplant: You receive transplantation of the stomach, pancreas and intestine.

In the most basic and common graft, an isolated intestinal graft, only sections of the jejunum and ileum are transplanted.

When is an Intestine Transplant Required?

If your medical condition falls into one of the following categories, you may be a candidate for an intestinal transplant:

• TPN related complications:
  • Parenteral nutrition-induced liver disease
  • Central venous catheter (CVC) related thrombosis of two or more central veins
  • Frequent episodes of central line sepsis
• Intestinal failure with intolerance to parenteral nutrition
  • Intestinal failure with high morbidity (frequent hospitalization, narcotic dependency) or inability to function
    Patient’s unwillingness to accept long-term home parenteral nutrition
• Short Bowel Syndrome (SBS). This is a malabsorption disorder caused by the surgical removal (resection) of large sections of the intestine.
• Chronic Intestinal Pseudo-obstruction (CIPO)
• Intra-abdominal non-metastasizing tumors

How is Intestine Transplant done?

Before the intestinal transplant, the patient is assessed thoroughly and made to undergo a battery of tests to ensure that the donor is healthy enough to survive the surgery. The test includes blood testing and various other investigations, physical assessment by the physician, the surgeon, an anesthetist, gastroenterologists, dietitians and other psychological tests.

The Intestine Transplant Selection Committee will present and discuss your results once your transplant evaluation is completed in order to provide the best possible recommendations about your ongoing medical treatment, surgical intervention, and suitability for intestinal transplant surgery.

You will begin the waiting period once you have been listed, and you may be called for transplant surgery at any time. The length of the wait is determined by the availability of the organ. You will be seen in the transplant clinic throughout this time and will need to have follow-up testing at regular intervals.

The length of surgery varies depending on what type of intestinal transplant you’re having. On an average, the intestine transplant takes about 8-12 hours.

What is the Recovery After an Intestine Transplant Like?

You will be shifted to the transplant intensive care unit (ICU) after the transplant surgery, where you will stay for a few days depending on how fast you recover. To ensure that the transplanted intestine survives in your body, you will need to take anti-rejection medications for the rest of your life.

The recovery procedure following an intestinal transplant is a long and sluggish one that tries to gradually improve the patient’s health and fitness. Resuming normal daily activities could take up to six months.

What Results Can I Expect from Intestine Transplant?

Because of advances in medical research, the number of people who have survived has increased over time. The survival rate of intestinal transplants is currently 70%, and in some cases much higher.