Intestine transplantation is also known as small bowel transplantation and intestinal transplantation. This is a last resort for people suffering from intestinal failure when they have had no significant success in treating this disorder with any other alternate non-surgical and surgical procedures.
In case a person is under total parenteral nutrition (TPN) for a long period of time they are likely to develop life-threatening complications such as catheter-related infections, bone disorders and even liver failure. It can also affect the veins used to administer nutrition through the catheter. In such cases it becomes necessary to perform an intestine transplantation of the small intestine to treat the fatal complications and improve the quality of life.
The major cause for requiring an intestine transplantation is the failure of the small intestine to absorb and process essential nutrients, electrolytes and fluids from the food. This functional failure causes various complications in the body such as homeostasis, energy misbalance, etc. An intestinal failure can be caused by various reasons that mainly result from nutritional, traumatic, infectious and metabolic complications that adversely affect the person's physiology and anatomy.
Several genetic and congenital factors are also responsible for causing intestinal failure in a person such as severe inflammation, bowel obstruction, ulceration, perforation and fistulas. The 'short bowel syndrome', which causes mal-absorption often due to the surgical removal of the small intestine, is the largest cause for an intestinal transplantation.
Surgical removal of the small intestine (short bowel syndrome) is the most common form of treatment for a number of congenital and gastroenterological conditions such as necrotizing enterocolitis, Crohn's disease, motility disorder, volvulus and tumors.
To evaluate the need for you to have an intestine transplant the doctor will check your medical history and perform various diagnostic tests to determine if you need an intestinal transplant.
These are the diagnostic tests:
There are three main types of intestines transplants that are performed, these are:
In this procedure the surgeon removes the diseased portion of the small intestine and replaces it with a donated healthy small intestine from a donor. This procedure is performed when the disease affects only the small intestine and there is no liver failure seen. This is a crucial treatment for persons suffering from irreversible intestinal failure.
This procedure is performed on patients who suffer from intestinal and liver failure as well. This procedure requires the surgeon to remove the diseased liver and intestine and implant a healthy liver and small intestine from a donor. Complications due to TPN (total parenteral nutrition), where the person is fitted with a catheter tube for administration of nutrition directly into the abdomen, are the main cause of liver failure which results in intestinal failure eventually. The life-span of patients after intestinal and liver failure gets drastically reduced to a few months.
Multi-visceral transplantation is performed in the event that two or more intra-abdominal organs (along with the intestines) suffer failure. The surgeon may need to transplant the stomach, pancreas, liver or the large intestine along with the small intestine in this procedure. This is a crucial and vital surgical procedure for people suffering from Gardner's syndrome, pre-malignant colorectal condition or intestinal pseudo-obstruction that cause multiple abdominal organs to fail.
The success rates of intestinal transplant procedures have improved vastly in recent years. At the one-year mark the graft-survival rates are estimated around 80% for isolated intestinal transplants and around 70% for combined liver-intestine and the multi-visceral transplant procedures. At the one-year mark the patient-survival rates are around 90% for isolated intestine transplant while the survival rates for the same time period for multi-organ transplants are the same.
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