Intestinal Transplant

Care after an intestinal transplant differs slightly for each child, depending on the medical history, type of transplant and medical condition at the time of the transplant. The length of stay in the hospital varies for each child and can range from several weeks to several months.

Immediately after your child's transplant, he or she will be taken to the intensive care unit (ICU) for close monitoring. A breathing tube will be inserted to help breathing. In most cases the tube can be removed within 24 hours after surgery. Many monitoring lines also will be attached. These too will be removed as your child becomes more stable.

When your child is ready to leave the ICU, he or she will be cared for in UCSF Children's Hospital. During this time, your child will have frequent blood draws, biopsies of the transplanted intestine through ileostomy and radiologic testing. These tests will help determine the health or your child's transplanted intestine. Your child also will begin weaning from total parenteral nutrition (TPN) and will slowly start feeding through a feeding tube with a liquid nutritional supplement. Over time, your child will start an oral diet.

After your child leaves the hospital, you will need to find local housing, if you live more than two hours away, until your child is stable enough to return home. Most children stay within the San Francisco Bay Area for two to six weeks after transplant and then are referred back to their primary and referring doctors.

During this time, your child will have weekly office visits, frequent biopsies of the transplanted intestine and lab work twice a week. You will stay in close contact with your child's nurse coordinator and can contact them at any time with questions or concerns.

Our social workers assist families with housing, including a San Francisco Ronald McDonald House. We also maintain listings of hotel and motel accommodations and can help you arrange short and longer-term accommodations. For information regarding hotels, motels and short-term apartment rentals in San Francisco, please visit our campus Housing Office Web site.

Once your child returns home, we work with your primary doctors to ensure that your child receives optimum care regarding the intestinal transplant as well as issues related to normal growth and development.

After the transplant, your child's body will respond to the transplanted organ as a "foreigner." His or her immune system will try to attack it. This is called "rejection." To help prevent rejection, your child will take medications called immunosupressants, which decrease the immune system's activity so it won't reject the transplanted organ. The risk of rejection never goes away, so transplant recipients need to take immonsuppressive drugs for life.

Although immunosupressants help reduce the risk of rejection, they also weaken the immune system, putting your child at a higher risk for infections. Your child will need to take medications to help prevent bacterial, fungal and viral infections. Some children also may require other medications.

Remember that an organ transplant is not a surgical cure, but rather a life-saving therapy that requires medication and close monitoring to be successful.

Over the last several years, success rates for intestinal transplants have improved dramatically. One-year survival rates for patients after intestinal transplant are more than 85 percent, comparable to liver transplant patients. Eighty percent of patients who have had an intestinal transplant are able to completely transition from total parenteral nutrition (TPN) to an oral diet and resume normal activities of daily living.

Intestinal transplantation does have some risks. The most common complication is rejection of the transplanted organ. During your child's recovery period, he or she will be closely monitored for rejection, which is most accurately diagnosed with a biopsy. In most cases, rejection can be treated with strong medications.

Bacterial, fungal or viral infections can develop in people following transplant because immunosuppressive drugs weaken the immune system. Your child will be given medications to help prevent infections.