Advances in medicine continue to dazzle, and as proof, consider the idea of intestinal transplants.
That's right. In a limited number of surgeries over the last few decades, doctors have successfully replaced the small intestine in patients suffering from various conditions that have wreaked havoc on their digestive system.
When these patients no longer had the basic ability to eat and digest food, the surgery restored it and saved their lives.
From the Intestinal Transplant Association, based in Montreal, Canada, here are a few things to know about the burgeoning field of intestinal transplants:
- It came of age in the 1980s, with related advances in infection-fighting and immune-suppressing drugs. The ITA says that thanks to intestinal transplants almost 1,000 patients have been able to go off intravenous feeding, resume a normal diet and lead a healthy lifestyle.
- The most difficult aspects of intestinal transplants are the large number of white cells in the bowel, too often setting the stage for rejection, and the large number of gut bacteria, increasing the risk of infection.
- Intestinal transplants are often the best option when intestinal failure is caused by short bowel syndrome, usually occurring after a significant part of the small intestine has been surgically removed, for various reasons.
- Other conditions, such as Crohn's disease, tumors, digestive tract obstructions, malabsorption and motility disorders, and autoimmune enteritis, can indicate the need for a transplant as well. Sometimes doctors perform a combined intestinal-liver transplant.
- Children can have a congenital malformation of the small bowel, sometimes indicating the need for a transplant. It might have to do with the length of the small intestine, the lack of nerve endings to stimulate the movement of stool, the problem of one portion of the bowel sliding into the next, or other factors.
- Although progress is being made, intestinal transplants are not yet routine surgical procedures. The ITA says, though, that such transplants have a survival rate comparable to, or better than, lung transplants.
- A limited number of medical centers around the country conduct intestinal transplants. Three well-known centers are Georgetown University Hospital, University of Wisconsin Hospital and the University of Arizona Medical Center.
Dr. Michael Sarr of the Mayo Clinic called small-bowel transplants the "new frontier" in organ transplants in an interview with Discovery's Edge, the Mayo's online research magazine.
"Though the results are improving at a steady rate each year, there still are many complications and a lot of dysfunction after surgery," he said.
He added that much work remains to be done not only in preventing organ rejection, but also in studying how the small bowel functions once it's transplanted. It's the latter area that he and his Mayo Clinic team are focusing on in their research.
"Intestinal Transplantation." Discovery's Edge: Mayo Clinic's Online Research Magazine." Web. 4 June 2012. http://discoverysedge.mayo.edu/intestinal_transplantation/index.cfm
"Information for Patients and Families." Intestinal Transplant Association. Web. 4 June 2012. http://intestinaltransplantassociation.com/?cat=7
"Intestinal Transplant." University of Arizona Medical Center. Web. 4 June 2012. http://www.azumc.com/body.cfm?id=983
Reviewed June 5, 2012
by Michele Blacksberg RN
Edited by Jody Smith