The Transplant Hospitalization
When an organ offer is obtained, the patient will undergo a rapid medial assessment to ensure that there are no major changes in the patient’s medical condition that might temporarily prevent transplantation. Once completed, the surgical team will assess the donor organ quality in an operation. If the donor organs are not deemed suitable, the transplant will be cancelled. If the organs are suitable, then the patient will proceed to the operating room at UCLA to be put to sleep under anesthesia and prepared for the transplant procedure.
Transplantation involving the intestine requires at least 6 hours and can last as long as 12 hours. During the procedure, diseased organ or organs are often removed. The exact operative plan will be outlined by your surgeon. The diseased intestine (and other organs) will be replaced by new organs. The blood flow in and out of the organ must be re-established. Once completed and blood flow restored, the intestine of the donor must be connected to the patient’s gastrointestinal tract. If a patient does not have a large bowel (colon), then a permanent ileostomy will be required. If a patient does have functional large bowel then the transplanted small intestine will be connected to this and a temporary ileostomy created. The presence of an ileostomy is important for assessing the function of the new intestine after surgery. Lastly, feeding tubes are placed into the patient’s stomach and small intestine in the postoperative period to provide medications and feedings.
The postoperative care will vary from patient to patient depending on their medical condition at the time of transplantation. Obviously the exact course for each patient cannot be predicted nor can outcomes be guaranteed. Every effort will be made to expedite the recovery process but patient safety is the biggest concern. In general, patients stay in the intensive care unit from 3 days to 4 weeks after the transplant. They may require support on a breathing machine (ventilator) during this interval. The length of hospitalization depends on a number of factors and can range from 4 weeks to 3 months. While in the hospital frequent exams and blood draws will be performed. Patients will be monitored according to their medical condition. Biopsies of the transplanted intestine will be obtained at regular intervals after the transplant. A specialized formula will be used to start feeding nutrients into the new intestine and the TPN will be weaned off as the intestine recovers function after the transplant procedure. Monitors, lines, and tubes will be removed as indicated.
Intestinal Transplant Links and Downloads
What is the Intestine: Introduction to Intestinal Transplantation
The United Network for Organ Sharing (UNOS) provides a toll-free patient services lines to help transplant candidates, recipients, and family members understand organ allocation practices and transplantation data. You may also call this number to discuss problems you may be experiencing with your transplant center or the transplantation system in general. The toll-free patient services line number is 1-888-894-6361
