Patients sometimes develop extremely serious problems that prevent them from absorbing essential nutrients through the intestine. Because rejection of the donor intestine remains a serious risk, doctors reserve intestinal transplantation for patients with life-threatening conditions including complications that can develop following long-term feeding through total parenteral nutrition and liver failure.
Potential candidates for intestinal transplantation include patients with:
Transplantation of a deceased donor's intestines is most commonly performed in children with short bowel syndrome. This may be an option for children with intestinal failure who have a functioning liver.
Advances in surgical technique, immunosuppressant medications, and post-operative monitoring have significantly improved survival rates in the last decade, rendering transplantation before liver failure a viable option.
Combined liver and intestinal transplantation is an option for patients with liver and intestinal failure, but who have a normal stomach and pancreas. In rare cases, the stomach, liver, pancreas, spleen, and intestine may all require transplantation. Transplantation of multiple organs is known as "multivisceral transplantation."
NewYork-Presbyterian transplant surgeons have also successfully performed ex-vivo transplantation in which surgeons removed five or more organs from patients with deeply embedded abdominal tumors, excise the tumors from the organs, and then reimplanted the patient's own organs.
Center for Liver Disease and Transplantation