Intestinal Rehabilitation and Transplantation Program
The Thomas E. Starzl Transplantation Institute provides isolated intestine (small bowel), combined liver-intestine, and multivisceral transplantation for patients who have irreversible intestinal failure. The program has performed more than 500 intestinal and multivisceral transplants on both adult and pediatric patients. This volume represents more than 25 percent of the total number of transplants worldwide.
Utilizing innovative immunosuppressive protocols, the patient survival rate has always been above national averages. To view specific information about our outcomes, including one- and three-year survival rates, please visit the Scientific Registry of Transplant Recipients (SRTR).
Most surviving patients are free of intravenous total parenteral nutrition (TPN) and enjoy an unrestricted oral diet. Equally impressive, is the successful reduction in the number of required medications that patients must take, particularly anti-rejection drugs with dosages now being spaced from every other day to two times per week. The Institute has the longest worldwide adult survivor who is beyond the 20 year milestone with excellent quality of life.
The three main types of intestinal transplantation offered by the Intestinal Rehabilitation and Transplantation Center (IRTC) are described below:
- isolated intestine (small bowel) transplantation
Some people are born with or develop irreversible intestinal failure. They become unable to digest food well enough to eat or be fed through a tube, and as a result require intravenous permanent total parenteral nutrition (TPN). The most common diseases are Crohn’s, blockage of the intestinal blood supply, and abdominal trauma. For these adults and children with the disease limited to the small bowel only, isolated intestine (small bowel) transplantation can be a lifesaving and life-enhancing option.
- combined liver and intestine transplantation
Combined liver and intestine transplantation is a lifesaving procedure for patients with combined organ failure. It is the only available treatment for patients with liver and intestinal failure. In most of these patients, TPN is the main cause of liver failure. Without treatment and with continuation of TPN, people with this condition have an expected median survival of six to 12 months.
- multivisceral transplantation
Multivisceral transplantation is offered to patients who have two or more failing intra-abdominal organs (including the intestines). The transplanted organs include the stomach, duodenum, pancreas, intestine, and liver. In patients with a healthy liver, the other organs are replaced and the liver is saved. The procedure is life-saving for patients with combined abdominal organ failure including those with pre-malignant conditions, such as Gardner’s syndrome, low-grade cancer of the gastrointestinal tract, pseudo-obstruction (abnormal motility of the gut), and those with thrombosed (clotted) veins of the intestine, liver, and spleen.