Intestinal Transplant

Intestinal transplant is often considered the last frontier of solid organ transplantation. However, intestinal transplant can provide the gateway to a more normal life when other treatments of intestinal failure, such as Total Parenteral Nutrition (TPN), fail. University Medical Center is one of the few centers in the United States willing to take on these very difficult cases. Our transplant surgical staff includes Dr. Rainer Gruessner, the surgeon responsible for developing the current surgical protocol for living related intestinal transplantation. 

Beyond improving and saving lives, intestinal transplant can also bring financial relief for those patients dependent on TPN. The cost for TPN when received at home can range from $200-$500 per day and $500-$1,500 per day when administered at a hospital. A lifetime cost on TPN far exceeds the cost of transplant. 

Why do I need an intestinal transplant?

There are many diseases that affect the intestines that could lead to failure. Typically, they deal with the intestine's ability to absorb nutrients. The following diseases will typically indicate intestinal transplantation:

In Adults:

• Ischemia, such as volvulus (abnormal twisting of the intestine), intussusception (one portion of the bowel slides into the next), thrombolic or embolic events (relating to blood coagulation problems)
• Traumatic injury of the bowel and its blood vessel
• Inflammatory bowel diseases, such as Crohn (bowel inflammation) disease
• Tumors, such as desmoid (developing in fibrous tissue), Gardner's disease or familial polyposis (an inherited disease of gastrointestinal polyps)
• Malabsorption and motility disorders

In Children:

• Congenital malformations, such as bowel/intestinal atresia (absence of a normal opening), aganglionosis (absence of ganglion/nerve cells), Hirschsprung disease (lack of nerve cells that enable intestinal muscles to move stool through large intestine), gastroschisis (opening in abdominal wall through which internal organs push outside of baby's body or microvillus inclusion disease (Congenital familial protracted diarrhea)
• Necrotizing enterocolitis (infection and inflammation of the intestines)
• Ischemia, such as volvulus or intussusception (one portion of the bowel slides into the next)
• Trauma
• Intestinal pseudo-obstruction
• Inflammatory bowel diseases, such as Crohn disease
• Mal-absorption disease

Procedures

Intestinal transplant is a complex and in-depth procedure. At UMC, our interest is with the patient, and as such, we require specific testing to make sure that transplant is the very best option for each patient. A patient that is referred to the Intestinal transplant program at UMC can expect to undergo various procedures for transplant surgery clearance.

These tests will be scheduled by your transplant coordinator, and will be performed at UMC. If you are a woman, you will require an annual pap smear, and if you are over 50, you will need a mammogram. The results of the above tests may indicate further testing to verify that transplantation is the absolute best option for you as a patient. Your transplant coordinator can assist with this. 

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