Intestinal Transplant
Procedure

Intestinal transplant is a complex procedure that requires the expertise of specialists trained in pediatric transplants. The surgery may take up to 12 hours and involves either an isolated intestinal transplant alone, a combined liver and intestine transplant, or a multi-visceral transplant. Depending on what caused your child's intestinal failure and his or her overall medical condition, your doctor will determine which type of transplant best meets your child's needs.

• Isolated Intestinal Transplant — An isolated intestinal transplant involves removing the diseased portion of the small intestine and replacing it with a healthy small intestine from a donor. This type of transplant is considered for children with complications caused by intestinal failure, who don't have liver failure.
• Combined Liver and Intestine Transplant — A combined liver and intestine transplant involves removing the diseased liver and intestine and replacing them with a healthy liver and intestine from an organ donor. This type of transplant is considered for children with intestinal failure and irreversible liver failure. The cause of liver failure in this setting is usually due to complications of intravenous nutrition.
• Multivisceral Transplant — A multivisceral transplant is rare and may be considered for children who have multiple organ failure, including stomach, pancreas, liver, small intestine and kidney failure.

Intestinal transplant involves removing the diseased organs and replacing them with healthy organs. First your child's blood vessels are connected to the donor's blood vessels to establish a blood supply to the transplanted intestine. The donor's intestine is then connected to your child's gastrointestinal tract.

An ileostomy is then made, which is a surgically created opening through which a portion of your child's small bowel, called the ileum, is brought up through the abdominal wall. After the transplant, this new opening on your child's abdomen allows body waste to pass directly out of the body and empty into a pouch. The ileostomy also allows the transplant team to assess the health of your child's transplanted intestine. In time, most children are able to have the ileostomy closed. A feeding tube is also placed into the stomach to help your child transition to an oral diet.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated July 14, 2010