Intestinal Transplantation Program
The Thomas E. Starzl Transplantation Institute provides isolated
intestine (small bowel), combined liver-intestine, and multivisceral
transplantation for patients who have irreversible intestinal failure.
The program has performed more than 450 intestinal and multivisceral
transplants which represents more than one-third of the total number of
adult transplants worldwide.
Utilizing innovative immunosuppressive protocols, the patient
survival has always been above the international average with:
- 96 percent survival at one year
- 90 percent survival at three years
- 82 percent survival at four years
Most surviving patients are free of intravenous total parenteral
nutrition (TPN) and enjoy an unrestricted oral diet. Equally
impressive, is the successful reduction in the number of required
medications that patients must take, particularly anti-rejection drugs
with dosages now being spaced from every other day to two times per
week. The Institute has the longest worldwide adult survivor who
is beyond the 18 year milestone with excellent quality of life.
The three main types of intestinal transplantation offered by the
Intestinal Rehabilitation and Transplantation Center (IRTC) are
described below:
- isolated intestine (small bowel) transplantation
Some
people are born with or develop irreversible intestinal failure. They
become unable to digest food well enough to eat or be fed through a
tube, and as a result require intravenous permanent total parenteral
nutrition (TPN). The most common diseases are Crohn’s, blockage of the
intestinal blood supply, and abdominal trauma. For these adults
and children with the disease limited to the small bowel only, isolated
intestine (small bowel) transplantation can be a lifesaving and
life-enhancing option.
- combined liver and intestine transplantation
Combined
liver and intestine transplantation is a lifesaving procedure for
patients with combined organ failure. It is the only available
treatment for patients with liver and intestinal failure. In most of
these patients, TPN is the main cause of liver failure. Without
treatment and with continuation of TPN, people with this condition have
an expected median survival of six to 12 months.
- multivisceral transplantation
Multivisceral
transplantation is offered to patients who have two or more failing
intra-abdominal organs (including the intestines). The transplanted
organs include the stomach, duodenum, pancreas, intestine, and liver.
In patients with a healthy liver, the other organs are replaced and the
liver is saved. The procedure is life-saving for patients with
combined abdominal organ failure including those with pre-malignant
conditions, such as Gardner’s syndrome, low-grade cancer of the
gastrointestinal tract, pseudo-obstruction (abnormal motility of the
gut), and those with thrombosed (clotted) veins of the intestine,
liver, and spleen.