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The intestine is the lower part of the digestive tract. It extends from the stomach to the anus. The upper part, the small intestine, is narrow and intricate
If your medical condition falls into one of the following categories, you may be a candidate for an intestinal transplant.
Intestinal rehabilitation is the science that stimulates the amazing ability of the intestine to adapt to different and unexpected medical and surgical conditions. It encompasses pharmacological, dietary, and surgical options that can return the intestine to a normal function.
When the intestine is irreversibly affected and rehabilitation is not possible, parenteral nutrition is the following step. Parenteral nutrition (PN) saves thousands of lives each year, but is not tolerated by everyone. Patients with a very short length of bowel, those who develop recurrent catheter related blood stream infection (CRBSI), or those who experience multiple central vein access thromboses may be at a higher risk of developing life threatening complications from the use of long-term PN. Indications for intestinal transplantation vary in the adult and pediatric populations.
A list of the most common causes for intestinal failure in the adult population is listed below:
A list of the most common causes for intestinal failure in the pediatric population is listed below.
If you are diagnosed with intestinal failure, the first step is to contact Cleveland Clinic’s Intestinal Rehabilitation and Transplant Center. Having a diagnosis of intestinal failure does not mean that you need an intestinal transplant; only a small number of patients with intestinal failure need a transplant. You may be an excellent candidate for intestinal rehabilitation and adaptation and be able to avoid or eliminate the need for parenteral nutrition.
Cleveland Clinic has one of the largest and most successful intestinal rehabilitation programs in the world. There are essentially two ways of optimizing the intestinal function in patients with intestinal failure: medical/dietary treatment and surgical treatment. Medical/dietary treatment includes diet adjustments and medications that are prescribed to improve digestive and absorptive function of the remaining bowel (growth factors, drugs that increase or decrease the intestinal motility, etc.). A small number of patients are found to have out-of-circuit bowel as a result of previous surgery that can be put back in continuity with the bowel that is exposed to food so that absorptive function can be improved. Furthermore, new surgical procedures (STEP, Bianchi and tapering procedures) are offered at our center to enhance the residual intestinal function. If existing medical and surgical treatments do not improve intestinal function, the patient is evaluated for PN and possibly intestinal transplantation.
This life-saving procedure is for people who have intestinal failure.
There are three types of intestinal transplants:
Most people who receive an intestinal transplant are on total parenteral nutrition (TPN) and can no longer eat solid food. Many have had complications with TPN and other treatments haven’t worked.
Reasons that may restrict you from having an intestinal transplant include:
The costs of intestinal transplant surgery vary based on your insurance, but they can be very high.
A credit analyst and social worker from intestinal transplant team will:
The intestinal transplant evaluation process is a series of outpatient tests, scans, and consults.
The transplant team will assess your:
The process takes a week to complete, and you must have a caregiver with you at all appointments.
The intestinal transplant experience is unique for each person.
Because people recover at different speeds, you will have frequent follow-up appointments for the first 3 to 6 months after surgery.
Once you leave the hospital, you will visit the outpatient clinic almost daily for the first few weeks.
As you recover, these visits will decrease to 2 or 3 times a week and then weekly. Once you’re eating solid foods and your doctor sees no signs of rejection or infection, you will visit us monthly for follow-up appointments.
Helping take care of an intestinal transplant patient is a big commitment.
The caregiver provides support throughout the entire transplant process and must come with you to all appointments during your evaluation.
After intestinal transplant surgery, he or she must stay with you 24 hours a day for a month or two.
An intestinal transplant caregiver will also:
You can have one person or a team of people to help care for you during the intestinal transplant process.
Caregivers can be your:
It all depends on a number of factors, but generally, 60 -75 percent of adult patients and 80 – 90 percent of children survive and are discharged from the hospital.
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