The Challenge: Intestinal Pseudo-Obstruction
From the moment she was born, Jennifer Alley Smith had a problem eating and gaining weight. Her doctors in Knoxville, Tenn., were at a loss to uncover the cause.
“I could eat a bite here or there, but with no nutritional factor,” says Jennifer.
It wasn’t until she was 7 years old, and weighed just 25 pounds, that doctors diagnosed her with intestinal pseudo-obstruction, a condition in which the small bowel can’t function properly and absorb nutrients.
Her doctors put her on a permanent intravenous solution of total parenteral nutrition, or TPN, which delivers all the nutrients the body needs directly into a vein.
“I had a gastric tube to empty my stomach,” says Jennifer. “Needless to say, I was a sick child. I couldn’t do normal things.”
Two years later, she and her family moved to Atlanta, Ga.
Numerous surgeries to try to correct the problem had her in and out of the hospital, but nothing seemed to help.
The Path to the UPMC Gastrointestinal Rehabilitation and Transplant Program
When she was 21 years old, doctors told Jennifer she needed a small bowel transplant.
“My liver was starting to have issues because of the TPN.”
Her gastroenterologist in Atlanta sent her to UPMC for an evaluation.
“At the time,” she remembers, “statistics for small bowel transplants weren’t wonderful. But UPMC was the number one center. The Starzl Transplant Institute was the first to do small bowel transplants. The best of the best was there.”
The Solution: Small Bowel Transplant
Once Jennifer was evaluated, things moved very quickly for her. Six weeks after she was put on the transplant list, she got the call.
“I was in surgery for 16 and a half hours, then I stayed in Pittsburgh for nine months for post-op. My parents came with me, and my new husband, whom I’d married right before the transplant.”
Jennifer admits it was a tough road.
“I had one round of severe rejection. Thankfully, the powerful antirejection drug called OKT3, worked.”
During her time in Pittsburgh, Jennifer developed a special relationship with her transplant team and, in particular, with her surgeon.
“All the care I received was very good. Several nurses were especially wonderful to me. And I’ve been happy with all the doctors,” she says. “They saved my life.”
The Results: Enjoying Food and Motherhood
Almost six years later, Jennifer is eating regular food and leading a regular life. Although she’ll always have to take antirejection and antidiarrhea drugs, she believes it’s worth it.
“No tubes. No bags. That’s a whole experience in itself.”
She professes that the first year after her transplant was hard. Her doctors had to find the right medications to regulate her body, and she had to learn to eat.
But having the life of a normal person is, as Jennifer says, “So worth it.”
“Now there’s not much I don’t enjoy eating,” she says. “I definitely enjoy my chocolate.”
Plus, she has another victory to claim. In 2008, Jennifer became the first adult small bowel transplant recipient to give natural birth to a healthy baby.
“He’s my little miracle,” she says.
Felton Steven Smith was named “Steven” after his mother’s donor. And her surgeon, Dr. Kareem Abu-Elgmad, now has a new nickname — “Grandpa Kareem.”
“I’ve been doing very well,” states Jennifer.
“I’m a stay-at-home mom, which keeps me very busy. We’d like to have another child when my husband gets out of law school. But I’m happy with what we’ve got right now.
“Having a transplant changes your life. I don’t take the little things for granted. I hope the future is just as good.”
Note: Jennifer's treatment and results may not be representative of all similar cases
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