Short Bowel Transplant for Intestinal Failure
An intestinal transplant can be a life-saving option when disease or trauma prevents nutrients from moving through the intestines and being absorbed by the body. Duke is one of the few hospitals in the U.S. with experienced transplant surgeons who perform intestinal transplants. Our team will help you through every step of this journey, from managing your condition before the transplant, through recovery and follow-up. We are here for you.
Intestinal Failure Treatment Options
Duke has a long history of treating adults with GI conditions including Crohn’s Disease, short bowel syndrome, trauma, or a small bowel tumor, all of which can lead to intestinal failure. Intestinal failure treatments may include:
- Intestinal rehabilitation, which can restore your body’s ability to absorb nutrients and may delay the need for transplant
- Total Parental Nutrition (TPN), which delivers nutrition intravenously through a catheter
However, if your condition is life-threatening, an intestinal transplant may be a better alternative.
When Intestinal Transplant Is Recommended
If an intestinal transplant -- also known as a small bowel transplant -- is recommended, you can feel confident choosing Duke for your care.
- Our transplant surgeons have performed hundreds of these complex procedures. In addition to intestinal transplants, we also perform multi-organ transplants that include the small intestine, liver, pancreas, and kidney.
- Our outcomes exceed the national average. According to the Scientific Registry for Transplant Recipients, 75 percent of our patients are alive with a functioning transplant one year after surgery, compared to a national average of 65 to 70 percent.
We successfully treat people who have been declined for an intestinal transplant at other hospitals.
Your Intestinal Transplant Team
The Duke intestinal transplant program is led by experts in hepatology (care of the liver, gallbladder, biliary tree, and pancreas) and transplant medicine, some of whom hold leadership positions in the Intestinal Rehabilitation and Transplant Association and the United Network for Organ Sharing (UNOS).
- As nationally respected leaders in the transplant field, our doctors and surgeons test new techniques and therapies and help set national guidelines. They also develop educational materials that are used when intestinal transplants are performed internationally.
- Our national involvement includes participation in clinical trials that test new therapies designed to improve nutrient absorption in people with intestinal failure, as well as ways to reduce transplant rejection. You or your child may be eligible to participate.
- Our team also includes transplant coordinators who help you navigate the process. These advanced-care nurses and our social worker can answer questions you or your caregivers may have about the wait time before the small bowel transplant, the surgery, financial concerns, physical and emotional issues, dietary requirements, and more.
- We are on-call for you 24/7/365. For urgent matters, an intestinal transplant coordinator is on-call 24 hours a day, 365 days a year. Additionally, an intestinal transplant doctor is on-call at all times for any needs that arise.
Becoming an Intestinal Transplant Candidate
The first step is an extensive evaluation with all members of the team to determine whether intestinal transplantation is the appropriate therapy. The process may include various tests and screenings such as blood tests, X-rays, and a liver biopsy. Our transplant coordinator will help you plan this evaluation.
Removes a small amount of tissue from the liver to help us determine whether you are a candidate.
The Intestinal Transplant Process
If the evaluation shows that intestinal transplantation would be appropriate for you, you will be listed in the national database maintained and administered by the United Network for Organ Sharing (UNOS). The average wait time is three to 12 months. Once you receive notification that an organ is available, you will need to arrive at Duke within six hours.
You and your caregivers will participate in transplant education classes to learn more about the experience, the medications you will need, and how to address your physical and emotional needs before and after transplant. If you need to temporarily relocate to the Durham, NC, area for your treatment, a transplant coordinator can also assist you in gathering resources and support.
Following the intestinal transplant, doctors will closely monitor your response to the surgery. We will prescribe and manage medications to prevent rejection. In addition, we perform routine small-bowel biopsies to monitor the transplanted graft. The length of time patients spend in the hospital post-transplant can vary from three weeks to three months. You will stay in the Durham area for follow-up care before returning home.
We involve your designated caregivers (family members or friends) from the time of your first evaluation through recovery. They attend each of your appointments, and we educate them about their important role in taking care of you before and after surgery. Since a caregiver should attend all appointments with you, we often recommend you choose two caregivers, in case one is not able to attend an appointment or if it is better for two caregivers to take turns caring for you.
These social worker-led sessions give you and your caregivers the chance to meet with others for emotional support, ask questions, and share information about issues such as medications, nutrition, and exercise as well as the psychological and emotional effects of your transplant experience.