Before Your Intestinal Transplant

Intestinal Transplant Evaluation and Waiting List

At the UPMC Gastrointestinal Rehabilitation and Transplant Program, we tailor the pre-intestinal transplant process to each person.

If you and your doctor think you may be a candidate for intestinal transplant, get a referral early. Outcomes improve with earlier referrals.

Even if you aren't a candidate yet, we can help manage your illness in our intestinal rehabilitation program.

Types of Intestinal Transplant Surgery

There are three types of intestinal transplant procedures. The type best for you depends on the severity of your disease.

Isolated Intestine (Small Bowel) Transplant

Who might benefit:

• People with organ failure limited to the small bowel and who do not have liver failure.
• Those with irreversible intestinal failure who are unable to digest food well enough to eat a normal diet.

Combined Liver and Intestine Transplant

Who might benefit:

• People who have liver and intestinal failure.
• Most people who continue on total parenteral nutrition (TPN) without other treatment have a median survival of less than 12 months.

Multivisceral Transplant

A multivisceral transplant includes the stomach, duodenum, pancreas, and intestine (with or without the liver).

Who might benefit: 

• People with gastrointestinal disorders that cause gut failure or life-threatening neoplasm.
• You may need this type of transplant when your intestine and two or more intra-abdominal organs are failing.

Intestinal Transplant Team

Once your doctor refers you to our center, we will assign you a transplant coordinator.

He or she will link you to the rest of your intestinal transplant care team of:

• Transplant surgeons
• Gastroenterologists
• Nutritionists
• Pain management specialists
• Pharmacists
• Psychiatrists
• Social workers
• Credit analysts

Pre-Intestinal Transplant Evaluation and Tests

If the transplant surgeon and gastroenterologist feel that transplant may be the best option for you, we will assign you to a credit analyst. The analyst will check your insurance coverage and discuss potential costs with you.

After we receive insurance approval, you can begin the pre-intestinal transplant evaluation process.

This series of outpatient visits takes a week to complete. You will need to stay near UPMC and have a caregiver with you at each appointment.

Family House offers affordable housing to people traveling to Pittsburgh for intestinal transplants.

Pre-Intestinal Transplant Tests

You will have a series of tests and scans to find out your risks and benefits from the surgery.

Because there are many options for intestinal transplant, tests and scans vary from person to person.

Some tests for intestinal failure may include:

• CT scans of the head, chest, and abdomen
• Colonoscopy
• Stress test
• Blood test
• Heart catheterization
• Pulmonary function testing
• Endoscopy
• Motility studies
• X-rays of the upper GI tract and small bowel

Intestinal Transplant Waiting List

After the evaluation — if you're eligible for an intestinal transplant — we will place you on the UNOS (United Network for Organ Sharing) intestinal transplant waiting list.

Because intestinal transplant is fairly uncommon, the wait list is short. However, the criteria for donor organs are specific.

The time on the list varies depending on what type of intestinal transplant you need.

For people who need a liver — as in a multivisceral transplant — your model for end-stage liver disease (MELD) score dictates your place on the waiting list. This score reflects the severity of liver disease. The higher the score, the higher your priority on the wait list.

While on the intestinal transplant waiting list, we:

• Use the results from your weekly lab tests for TPN to keep your status updated.
• Continue to manage your condition medically.

If Intestinal Transplant Isn't Right for You

In many cases, our team can treat intestinal health problems — and even help people eat solid food again — without the need for a transplant.

We will always try all medical treatment options before advising intestinal transplantation.