Care after an intestinal transplant differs slightly for each patient, depending on their medical history, type of transplant and medical condition at the time of their transplant. The length of stay in the hospital varies for each patient, but can last for several weeks or as long as several months.
Immediately after your transplant, you will be taken to the intensive care unit (ICU) where you will be closely monitored. When you are ready, you will be transferred to our transplant ward where you will be monitored and cared for by our team of transplant experts, including doctors, nurses and nurse practitioners, dieticians, pharmacists and social workers. During this time, you will have frequent blood draws, biopsies of the transplanted intestine through the ileostomy and radiologic testing. These tests will help determine the health or your transplanted organ. You also will begin the process of weaning from total parenteral nutrition (TPN) and will slowly start feeding through your feeding tube with a liquid nutritional supplement. Over time, you will start an oral diet.
After you leave the hospital, you will need to stay locally if you live more than two hours away, until your doctor determines that you are stable to return home. We 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 Website.
During this time, you can expect weekly office visits, frequent biopsies of the transplanted intestine and lab work twice a week. You will stay in close contact with your nurse coordinator and can contact them at any time with questions or concerns regarding your health. Your support person also will need to stay with you during this time to help with your daily activities, taking you to testing and medical appointments.
After your transplant, your body will think of the transplanted organ as a "foreigner," and therefore your immune system will try to attack it. This is called "rejection". To help prevent rejection from occurring, you will take immunosuppressive medications, which decrease your immune system’s activity so that it won't reject your transplanted organ. The risk of rejection never goes away, so transplant recipients need to take immunosuppressive drugs for life.
Although immunosuppressive medications help reduce your risk of rejection, they also weaken your immune system, putting you at a higher risk for infections. For this reason, you will need to take medications to help prevent bacterial, fungal and viral infections. Some patients also may require blood pressure, diabetes or anti-ulcer medications.
It is important to remember that an intestinal transplant is not a surgical cure, but rather a last-resort therapy that requires meticulous administration of medication and close monitoring to be successful.
Over the last several years, success rates for intestinal transplant have improved dramatically. One-year survival rates for patients after intestinal transplant are more than 85 percent, which is 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 transplant does have some risks. The most common complication is rejection of the transplanted organ. During your recovery period, you 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. You will be given medications to help prevent infections.
Transplant recipients face increased risks for cancer such as skin cancer and lymphoma, a side effect of some immunosuppressant drugs, and should be closely monitored for these conditions.
Reviewed by health care specialists at UCSF Medical Center.
Intestinal Rehabilitation and Transplantation Program
350 Parnassus Ave., Suite 410
San Francisco, CA 94143
Phone: (877) 762-6935, (415) 353-2336
Fax: (415) 353-8917