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The Intestinal Transplant Program at Cincinnati Children’s provides comprehensive, innovative care for patients with short bowel syndrome, congenital enteropathies and pseudo-obstructions. With a one-year post-transplant survival rate of 100 percent according to the Scientific Registry of Transplant Recipients, our surgical outcomes are among the best in the United States.
Innovation is a hallmark of our program’s success. For example, our team:
Transplant surgery is considered a last resort. Some patients are able to avoid it by participating in our Intestinal Rehabilitation Program, which offers extensive treatment options and training to help patients manage their long-term medical needs. Other patients have the option of undergoing autologous intestinal reconstructive surgery (e.g., bowel lengthening and tapering) in order to preserve bowel function and avoid transplant.
When a transplant is necessary, our team utilizes effective strategies to improve outcomes. Examples include:
Because some patients have disorders of the nerves or muscles of the gastrointestinal tract, the movement of food down the gastrointestinal tract may be so disorganized that they develop intestinal failure needing intravenous nutrition. In those situations, complications such as liver failure, loss if central venous access and life-threatening blood stream infections may occur. When they do occur, some transplant programs remove the patient's stomach, duodenum, the rest of the small and large intestine, and possibly the liver, replacing all of them with new organs. This procedure is called a multi-visceral transplant or a modified multi-visceral transplant. Our team prefers to leave intact a small amount of native stomach and to sew it directly to the transplanted small intestine. The excellent results we have enjoyed leaving in part of the native stomach prompt us to avoid multi-visceral transplantation if possible.
Intestinal transplants are sometimes needed due to:
Patients will come to Cincinnati Children's Hospital Medical Center for a week-long admission to undergo testing to determine if they are a candidate for small bowel transplantation.
The transplant team works with the local and national transplant lists to find an appropriate organ(s). Organ allocation is based on medical urgency, time on the waiting list and blood type compatibility.
The transplant surgeon removes the donor organ, removes the recipient's damaged small bowel and then attaches the new donor small bowel.
Most small bowel transplant recipients spend several weeks in the hospital. This is longer than for other types of organ transplant. The team will monitor the recipient for rejection, infection and other complications.
Surgeons at Cincinnati Children’s have performed 44 small intestine and combined small intestine-liver transplants. Our outcomes are enhanced by our experience in performing the most complex transplants, including segmental and in situ split.
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