Intestinal failure occurs when someone intestines can’t absorb the nutrients and fluids required for normal growth, development and keep fluid and nutritional balance. Patients with intestinal failure require parenteral nutrition (PN) support in the form of fluids and nutrients. When someone develops complications related to PN or the central venous catheter needed to provide this support an intestinal transplant may be necessary. This procedure is rare and should be performed by a highly skilled team of experts. NewYork-Presbyterian is one of the few transplantation centers in the United States to offer intestinal transplantation. We have the compassion, experience, and resources to care for people who need this highly sophisticated lifesaving therapy.
Experts in Intestinal Transplantation
The intestinal failure team at NewYork-Presbyterian includes highly experienced surgeons, gastroenterologists, nurse practitioners, social workers, psychiatrists and nutritionists. Your team members are here for you every step of the way to help you through what is typically a difficult decision and lengthy recovery. Advances in surgical technique, immunosuppressant medications, and monitoring after transplantation have significantly improved the outcome of this procedure.
National Leader in Intestine Transplant
A History of Excellence in Transplantation
The NewYork-Presbyterian transplant team has been performing small bowel transplantation for more than two decades. Our team has achieved 100 percent patient at graft survival one year after transplantation in pediatric patients. We are a leader in research related to intestinal transplantation. Our team has presented our work at national and international conferences. We have published that the presence of donor white blood cell in the recipient's blood could be protective of rejection.
Ex Vivo Procedure (ex vivo resection and autotransplant) to Remove Complex Abdominal Tumors
NewYork-Presbyterian is a world leader in ex vivo procedures: removing multiple organs from people with deeply embedded abdominal tumors, dissecting out the tumors from the organs, and reimplanting the organs back into the patient. We use the ex vivo approach to remove tumors that are inoperable using conventional surgery. For example, our surgeons removed 15 pounds of a liposarcoma entangling the organs of a 59-year-old man. They also performed ex vivo procedure in a seven-year-old girl to remove a deep tumor growing into major blood vessels of her abdominal organs — for that procedure surgeons temporary removed all of her abdominal organs (6 organs) and auto-transplanted the vital ones.
Historic "Six Organ" Surgery Press Conference
This press conference at NewYork-Presbyterian Hospital in New York City from March 2009 discusses the historic surgery on a seven-year-old girl from Long Island. The girl had a large abdominal tumor growing amongst numerous organs. Most surgeons considered the case inoperable, but Dr. Tomoaki Kato devised a plan. In a 23-hour surgery, Dr. Kato removed the six organs surrounding the tumor; then removed the tumor itself; and returned the organs. The case is considered the first of its kind in the world.
Leaders in Multivisceral (Combined) Transplants
Some people with both liver and intestinal failure will require combined liver and intestinal transplantation. In other cases, the function of the stomach and pancreas is compromised, and patients may received the stomach, liver, pancreas, spleen, and intestine at the same time, this procedure is considered a multivisceral transplant. The strength of the transplant program at NewYork-Presbyterian and the expertise of our transplant team make our institution an internationally renowned hospital for these complex procedures.
Who Is Eligible for Intestinal Transplantation?
Because rejection of the donor's intestine remains a serious risk, our doctors reserve intestinal transplantation for people with life-threatening conditions. Complications such as loss of venous site to insert catheter to administer PN, bacterial and fungal infections associated with catheter, or liver failure associated with PN toxicity can occur. You or your child may have an indication for intestinal transplantation if you have:
- Short gut syndrome (the most common reason for intestinal transplantation in children)
- Intestinal dysmotility (problems moving food through the intestine)
- Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
- Intestinal trauma
- Volvulus (twisting of the intestine that causes obstruction)
- Recurrent obstruction of the intestine
- Necrotizing enterocolitis (inflammation and death of intestinal tissue, most often in premature infants)
- Gastroschisis (intestines growing outside a baby's body, through the wall of the abdomen)
- Certain tumors (such as Gardner’s syndrome with desmoids tumors)
- Mesenteric vascular thrombosis (blood clots in blood vessels supplying the intestine)
- Radiation enteritis (inflammation of the intestine due to radiation therapy)
- Developed liver failure due to PN
Patients need to undergo an extensive evaluation to determine that other organs in your body are working well and will be healthy enough to support you during this difficult procedure.
Lifelong Follow-Up and Support
Transplantation is a life-saving procedure. You'll need life-long immunosuppressant medications and careful monitoring. Throughout the transplant process and beyond, we help you and your family navigate any emotional, financial, and logistical concerns you may have. Our transplant team is here for you — for life.
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NewYork-Presbyterian/Columbia University Irving Medical Center
Center for Liver Disease and Transplantation