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Small Intestine Transplantation

by Martin Hertl, MD, PhD, Paul S. Russell, MD

Transplantation of the small intestine may be done when people cannot get enough nutrients because

  • They have a severe disorder that prevents the intestine from absorbing nutrients.

  • The intestine had to be removed because of a disorder or injury.

  • They need to be fed intravenously (total parenteral nutrition) but can no longer can be because of problems, such as liver failure or recurring infections.

After 3 years, more than 50% of small intestine transplants are still functioning, and about 65% of people who have had an intestinal transplant are still alive.

Complications

Intestinal transplants are particularly prone to both infection and rejection. Once a week, After transplantation, doctors use a viewing tube (endoscope) to check the intestine for signs of rejection. This test is done frequently, sometimes once a week, at first. Then the test is done every few weeks, then every few months.

Because the small intestine contains a large amount of lymphatic tissue, the new intestinal tissue may produce cells that attack the recipient’s cells, causing graft-versus-host disease.