Intestinal transplant

Intestinal transplantation is a surgical treatment for intestinal failure. It is one of the most rarely performed transplant procedures performed, exclusively involving the transplantation of donor small bowel to a recipient, with an ileostomy formation. 

Due to the high risk of complications with the procedure, it is usually reserved for patients with intestinal failure who are unable to be sustained on total parenteral nutrition (TPN) due to complications of TPN treatment 1,2

With continued improvements in donor selection, organ preservation and operative techniques recent studies report improvements in outcomes from intestinal transplants to be comparable with that from lung transplantation 7.

There are two main patient groups that are candidates for small bowel transplantation:

Both live donor and cadaveric operations are performed depending on whether intestinal transplant is being performed in isolation or combination with other visceral transplants.

  • the intestinal graft can either have venous drainage via the IVC or via portal system (superior mesenteric vein)
  • arterial anastomosis to abdominal aorta, usually infrarenal
  • intestinal anastomosis as for live donor
  • concomitant liver failure related to TPN
  • hypercoagulable states causing intestinal failure that are correctable with liver transplantation
  • arterial anastomosis between a patch of donor aorta including the celiac axis and SMA origin to recipient aorta
  • donor-recipient portoportal venous anastomosis
  • cavocaval venous anastomosis
  • Roux-Y-choledocho-enterostomy for biliary drainage
  • used in patients with invasive abdominal malignancies requiring multiorgan curative surgical resection 

Article information

rID: 49838
Tag: cases, cases
Synonyms or Alternate Spellings:
  • Gut transplant
  • Gut transplantation
  • Bowel transplantation
  • Intestinal transplantation
  • Bowel transplant

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