Intestinal Transplant

Short Bowel Transplant for Intestinal Failure

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An intestinal transplant can be a lifesaving option when disease, trauma, or problems with a previous bowel resection surgery prevent 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.

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Becoming an Intestinal Transplant Candidate

Extensive Evaluation


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.

Liver Biopsy


Removes a small amount of tissue from the liver to help us determine the health of the organ. If there is a lot of scar tissue, you may also need a liver transplant at the same time as your intestinal transplant. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Intestinal Failure Treatment Options

Duke has a long history of treating adults with GI conditions including Crohn’s Disease, short bowel syndrome, trauma, a small bowel tumor, and others, all of which can lead to intestinal failure. Intestinal failure treatments may include:

  • Intestinal rehabilitation, which uses medication or surgery to restore your body’s ability to absorb nutrients and possibly delay the need for transplant
  • Total Parenteral Nutrition (TPN) to deliver nutrition intravenously through a catheter

However, if your condition is life-threatening, an intestinal transplant may be a better alternative. 

New Patient Appointment

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). Once you receive notification that an organ is available, you will need to arrive at Duke within six hours.

Transplant Education


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 one to three months. After leaving the hospital, you will stay within one hour of Duke for follow-up care before returning home. This can range from three to six months or longer, depending on your progress.  

Your Caregivers Are Our Partners


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.

Your Intestinal Transplant Team

Experts in Intestinal Transplant
The Duke intestinal transplant program is led by experts in hepatology (care of the liver) and transplant medicine, some of whom hold leadership positions in the Intestinal Rehabilitation and Transplant Association and the United Network for Organ Sharing (UNOS). Our transplant surgeons have successfully treated people who have been declined for an intestinal transplant at other hospitals. In addition to intestinal transplants, we also perform multi-organ transplants that include the small intestine, liver, pancreas, stomach, colon, and kidney.

National and International Leaders
As nationally respected leaders in the transplant field, our doctors and surgeons test new techniques and therapies and help set national guidelines. We also develop educational materials that are used when intestinal transplants are performed internationally.

Dedicated Hospital Unit for Transplant Patients
Our solid organ transplant unit is dedicated to caring for people throughout their organ transplant journey, whether they are waiting for a transplant, recovering from surgery, or are returning to the hospital. The unit is staffed by a dedicated team of providers experienced in caring for people undergoing liver, kidney, small bowel, pancreas, or intestinal transplants. These include doctors, nurses, pharmacists, social workers, patient coordinators, and more. Patients and their families can establish relationships with our providers and staff and feel secure in the hospital environment.

Access to Clinical Trials
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.

Dedicated Transplant Coordinator
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.

On Call 24/7/365
For urgent matters, a 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.

Best Hospital for Gastroenterology and GI Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our gastroenterology and GI surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 01/17/2022 by