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Small Intestine Transplantation

By

Martin Hertl

, MD, PhD, Rush University Medical Center

Last full review/revision Jun 2020| Content last modified Jun 2020
Click here for the Professional Version

Small intestine transplantation is the removal of the small intestine from a recently decreased person and then the transfer of the small intestine, sometimes with other organs, into a person who cannot get enough nutrients because of a disorder of their small intestine.

Transplantation of the small intestine may be done when people cannot get enough nutrients because

Small intestine transplantations are being done less frequently because there are new treatments and techniques that make transplantation less necessary.

After 3 years, more than 50% of small intestine transplants are still functioning, and about 65% of people who have had an intestinal transplant are still alive.

Procedure

The small intestine can be transplanted alone or with other organs—a liver, stomach, and/or pancreas. These procedures can be very complicated.

A surgeon removes the diseased part of the recipient's small intestine and replaces it with a healthy piece of small intestine from the donor. The blood vessels of the recipient and the transplant are connected, and the donor's intestine is connected to the recipient's digestive tract.

Part of the transplanted small intestine is connected to an opening through the abdominal wall to the skin—called an ileostomy. This opening enables doctors to monitor how well the transplant is functioning and to check for problems. Usually, the opening can be closed after a period of time. While the ileostomy is present, body wastes pass through it and empty into a pouch.

Complications

Rejection

Rejection occurs at least once in about 30 to 50% of people within a year after small intestine transplantation. Symptoms include diarrhea, fever, and abdominal cramps.

After transplantation, doctors use a viewing tube (endoscope) to check the intestine for signs of rejection. This test is done frequently, sometimes once a week, at first. Then the test is done every few weeks, then every few months.

Graft-versus-host disease

Other complications

Sometimes the new intestinal tissue develops problems with blood vessels and thus lacks enough blood supply. The tissue needs to be surgically removed. People may also eventually develop a blood cancer called lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. These... read more Overview of Lymphoma .

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