Intestinal Transplant

Intestinal Transplant

Evaluation
Procedure
Recovery

Procedure

Intestinal transplant is a complex procedure that requires the expertise of specialists trained in performing pediatric transplants. The surgery may take up to 12 hours and involves either an isolated intestinal transplant alone, combined liver intestine transplant, or a multi-visceral transplant. Depending on the cause of your child's intestinal failure and their overall medical condition, your doctor will determine the type of transplant that best meets your child's needs:

• Isolated Intestinal Transplant -- An isolated intestinal transplant involves removing the diseased portion of the small intestine and replacing it with a healthy small intestine from a donor. This type of transplant is considered for children with complications caused by intestinal failure, but who do not have liver failure.
• Combined Liver Intestine Transplant -- A combined liver and small intestine transplant involves removing the diseased liver and intestine and replacing them with a healthy liver and intestine from an organ donor. This type of transplant is considered for children with intestinal failure who also have irreversible liver failure. The cause of liver failure in this setting is usually due to complications of intravenous nutrition.
• Multivisceral Transplant -- A multivisceral transplant is rare and may be considered for children who have multiple organ failure, including stomach, pancreas, liver, small intestine and kidney failure. This type of transplant involves removing the diseased organs and replacing them with healthy organs from a donor.

Intestinal transplant involves removing your child's diseased small bowel and/or other organs, and replacing them with healthy organs. First your child's blood vessels are connected to the donor's blood vessels to establish a blood supply to the transplanted intestine. The donor's intestine is then connected to your child's gastrointestinal tract.

An ileostomy is then created, which is a surgically created opening through which a portion of your child's small bowel, called the ileum, is brought up through the abdominal wall. After the transplant, this new opening on your child's abdomen -- the ileostomy -- allows body waste to pass directly out of the body and empty into a pouch. The ileostomy also allows the transplant team to assess the health of your childs transplanted intestine. In time, most children are able to have the ileostomy closed. A feeding tube is also placed into the stomach to help your child transition to an oral diet.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007