Intestinal and Multivisceral Transplant

An intestinal transplant or multivisceral transplant can be a life-saving option when disease, trauma, or problems arising from a previous surgery prevent nutrients from traveling through the intestines and absorbing into the body. Small intestines that are diseased or experiencing failure can be transplanted by themselves or with other abdominal organs, depending upon the needs of the patient.

• The small intestine is the most important part of the digestive system. Most people can live without a stomach or large intestine, but it is harder to live without a small intestine.
• Intestinal failure can be caused by disease or by trauma, which then affects how the intestine absorbs nutrients or moves food through the intestinal tract.
• Intestinal and multivisceral transplantation can be used to treat a variety of conditions, such as intestinal failure, small bowel disease, Crohn’s disease, cancer, and more.
• A common cause of intestinal failure in children is short bowel syndrome (SBS).

Intestinal and multivisceral transplantations are performed in people with irreversible intestinal failure. The purpose of this transplant is to restore intestinal function and to treat intestinal failure when other treatments, such as parenteral nutrition, have not been successful. The procedure is done by removing the diseased portion of the small intestine and replacing it with a healthy small intestine from a donor.

Intestinal transplantation can be performed alone or as part of a multivisceral transplant that may include any combination of organs in the gastrointestinal tract.

A number of different conditions can make an intestinal or multivisceral transplant necessary. The following are some of the most common:

Evaluation is a necessary part of the transplant process, as it is used to determine a patient’s eligibility for the procedure and to determine the unique risks and benefits to that patient. Our adult and pediatric intestinal transplant team will conduct a thorough evaluation that may span from several days to several weeks, and involves different health care professionals including:

During the assessment, our team reviews the patient’s medical history, conducts a physical assessment, and performs a series of tests that may include:

During intestinal and multivisceral transplantation, the diseased intestine and/or some combination of other organs are surgically removed and replaced with healthy organs. The blood vessels of the patient are connected to the donor organs in order to establish a blood supply to the transplanted organs. The donor’s intestine is then linked with the patient’s gastrointestinal tract.

When an organ becomes available and a patient is matched, the transplantation operation will begin as soon as possible. The patient will be asked to arrive at the hospital for physical exams and surgery preparation. Once the preoperative testing is completed, the patient will be transported to the operating room.

The transplant procedure will take approximately eight to 12 hours and will include the following steps:

1. General anesthesia is administered.
2. A transplant surgeon makes a long incision across the abdomen.
3. The abdominal organs are examined for signs of infection or anything else that could interfere with successful transplantation.
4. The organs being replaced are removed.
5. 5. The surgical team implants the donor organs and attaches them to the recipient body’s veins, arteries, and any other vital connections.
6. The surgeons ensure all bleeding is controlled.
7. The incision is closed.

While some medications and therapies may be able to delay organ failure or alleviate symptoms, surgery is the only way to treat severe gastrointestinal conditions such as intestinal failure.

Intestinal and multivisceral transplantation are highly complex operations, which means they come with significant risks. Possible complications after intestinal and multivisceral transplant include:

Intestinal and multivisceral transplantation saves lives, but it requires a lifelong commitment to ongoing monitoring and to taking anti-rejection medications. Frequent medical supervision will still be necessary after a transplant, but this does decrease over time.

Intestinal and multivisceral transplantation recovery will begin in the intensive care unit (ICU). The patient will receive post-surgical monitoring that constantly evaluates whether the body is accepting the new organ/organs, along with intravenous (IV) fluids, nutrition, and medicines. Typically, patients will remain hospitalized for several weeks after transplant surgery but this can vary from patient to patient.

Patients will have to take a variety of medications after their surgery. Some medications, such as immunosuppressants, will likely have to be taken for the rest of their lives. Among the medications a patient might receive post-surgery are:

If you have a serious disorder of the intestinal tract that is affecting your ability to obtain nutrition by eating and drinking, our team is well prepared to evaluate your condition and determine the best course of treatment. That might be a transplant of the small intestine, a multi-organ transplant, or our state-of-the-art intestinal rehabilitation program.

Our multidisciplinary team focuses on saving the lives of children and adults, and restoring the best possible function of the digestive tract.