It is a surgical process in which sections of the small intestine are removed due to intestinal failure. Then that part is replaced with a deceased donor. This process is also known as small bowel transplantation. The situation arises when an intestine no longer functions properly is called intestinal failure. There are many reasons which arise such as gastrointestinal disease. It can be a life-threatening problem. This makes the small intestine incapable to absorb electrolyte, fluids and nutrients from the food.

According to some research data, it is found that 300 intestinal transplantation have been done successfully. Many individuals are dealing with such bowel disorder and looking for the best treatment. Here, patients and their closed ones can get to learn about intestinal transplant types, symptoms, causes and its procedure.

Types of Intestinal Transplant

It is of three types which are as follows:-

1. Intestinal Graft

It is a common type of grafting in which only two segments are removed. The ileum and jejunum are these segments which are replaced with a deceased donor.

2. Intestinal-liver Graft

It is a combined procedure in which these organs are replaced due to severe liver dysfunction. This disorder is caused because of Parenteral nutrition or PN enzyme. In this transplantation liver is transplanted at the same time with the intestine.

3. Multivisceral Graft

This grafting is required to treat underlying conditions of the digestive system. It includes the various parts, such as the small intestine, liver and other abdominal organs; pancreas and stomach.

Why is Intestinal Transplantation Required?

There are various causes and signs of transplant failure due to which this transplantation is required:-

Symptoms

Vomiting
Diarrhea
Bloating
Malabsorption of nutrients
Fatigue
Lack or poor appetite
Decreased weight
Foul-smelling stool

Causes

Radiation
Short bowel syndrome
Celiac disease
Crohn’s disease

Intestinal Transplant Procedure

This transplantation is done in the following ways:-

1. Diagnosis

Before starting the treatment, running diagnostic tests are important to get better result. Your doctor will the run the following advanced tests:-

Gastroduodenal manometry
Blood tests
Upper endoscopy
Abdominal X-ray
Screening through Colonoscopy
Lower GI series testing
Abdominal CT scan

2. Procedure

Preoperative Evaluation

There are some assessments required before starting an operation. Recipient and donor blood group, serological tests, HLA typing, weight , length and function of the bowel.

All these tests are done in order to match a donor with a recipient to reduce the risk of organ rejection and an effective recovery. The recipient should not be too young or too old because it affects the transplantation procedure and its recovery time. Both donor and recipient should meet the requirement of compatibility to reduce the threat of rejection of the intestine. So it is important to ensure histocompatibility to avoid any infection.

Transplantation Procedure

Your doctor suggests not eating and drinking a couple of hours before starting the process. After matching the intestine organ, the complicated procedure of the transplantation is performed by a surgeon. After selecting a donor, then some pretreatments are done to kill microscopic organisms by decontaminating with many antibiotics. It has the following protocol:-

Intestinal Transplant Alone

It includes the following steps of the procedure:-

Local anaesthesia is given to the patient. Then the non-functional small intestine is replaced with a healthy one which is removed by a surgeon.
Now a healthy piece of small intestine from the donor is grafted to the recipient’s digestive tract. While ensuring the blood vessels are connected properly.
Then ileostomy is done by making this transplanted organ to get connected with an artificial opening in the abdominal wall.

Combined Liver- Intestine Transplantation

It is a modified multivisceral transplant which is done by transplanting the liver with a small intestine. It is a very complicated procedure which is suggested to those who have multiple organs failure. This is done in the following steps:-

An individual is prepared for an operation by giving anesthesia. It makes you fall asleep during the procedure.
This process leads to huge blood loss, so it is important to collect and re-circulate it into your bloodstream. It is done by performing blood transfusion. Sometimes, plasma or platelets are additionally required to help with clotting.
The doctor makes a cut in the abdomen, then a non-working portion of the liver along with other organs. Such as pancreas, kidney and stomach are removed and replaced with healthy ones from the donor.

Postoperative Period

After completing the procedure, the patient remains in the ICU under observation. During this time, the surgeon monitors the risk of rejection, infection and other complications. Your healthcare provider will advise you to take pain relieving medicines. The patient has to take nutrients through a catheter. It is because these transplanted organs take time to heal and are not able to absorb nutrients from the food which is taken orally.