Intestinal Transplant Surgery Frequently Asked Questions

This life-saving procedure is for people who have intestinal failure.

There are three types of intestinal transplants:

• Small bowel only.
• Liver and intestine.
• Multivisceral — this type of transplant may include the stomach, duodenum, pancreas, intestine, and liver.

Most people who receive an intestinal transplant are on total parenteral nutrition (TPN) and can no longer eat solid food. Many have had complications with TPN and other treatments haven't worked.

At the UPMC Gastrointestinal Rehabilitation and Transplant Program, we tailor care to meet your unique needs.

Your doctor will need to refer you to the UPMC Gastrointestinal Rehabilitation and Transplant Program by calling 877-640-6746.

We will need your:

• Medical history
• Recent lab work
• Health insurance information

Once referred, you will meet with the intestinal transplant team to discuss the risks and benefits of surgery, as well as options for intestinal rehab.

The earlier you receive a referral, the better the outcome.

Reasons that may restrict you from having an intestinal transplant include:

• Cancer (you must be cancer-free for 5 years).
• Infectious diseases such as HIV.
• Lung or heart disease that won't allow you to endure surgery.
• The inability to stick to the treatment plan before or after transplant.

If you're not a candidate for intestinal transplant, we have many treatment options at UPMC. Almost 70 percent of people referred to our center benefit from our intestinal rehabilitation program without needing a transplant.

The costs of intestinal transplant surgery vary based on your insurance, but they can be very high.

A credit analyst and social worker from UPMC's intestinal transplant team will:

• Work with you to understand your insurance coverage.
• Give you a packet with details about your benefits and potential out-of-pocket costs for your intestinal transplant.
• Help you find financial assistance if you can't cover the costs of your intestinal transplant.

UPMC participates with the following insurance provider networks:

• Aetna Institutes of Excellence^™ Transplant Facilities
• CIGNA LifeSOURCE Transplant Network^®
• OptumHealth Transplant Centers of Excellence Network
• UPMC Health Plan^®

The intestinal transplant evaluation process is a series of outpatient tests, scans, and consults.

The transplant team will assess your:

• Gastrointestinal system
• Body's ability to handle intestinal transplant surgery
• Mental and emotional health
• Health history that might affect your success from transplant.

The process takes a week to complete, and you must have a caregiver with you at all appointments.

Depending on your health status, you may want to relocate to Pittsburgh during the intestinal transplant process.

• For your transplant evaluation, you will need to stay for a week.
• While on the intestinal transplant waiting list, you will need to live within 4 hours of UPMC so you can arrive on time for surgery.
• After your intestinal transplant, you will need to stay for 3 to 6 months for follow-up appointments.

Family House offers an affordable home away from home for people traveling to Pittsburgh for an intestinal transplant.

The intestinal transplant experience is unique for each person.

Because people recover at different speeds, you will have frequent follow-up appointments for the first 3 to 6 months after surgery.

Once you leave the hospital, you will visit the outpatient clinic almost daily for the first few weeks.

As you recover, these visits will decrease to 2 or 3 times a week and then weekly. Once you're eating solid foods and your doctor sees no signs of rejection or infection, you will visit us monthly for follow-up appointments.

Helping take care of an intestinal transplant patient is a big commitment.

The caregiver provides support throughout the entire transplant process and must come with you to all appointments during your evaluation.

After intestinal transplant surgery, he or she must stay with you 24 hours a day for a month or two.

An intestinal transplant caregiver will also:

• Help you get to and from the bathroom after surgery.
• Make sure you take medicines in the right doses at the right times.
• Help you record all information that the intestinal transplant team requested.
• Drive you to and from your follow-up appointments at UPMC.
• Look for signs that you're behaving unusually.
• Contact your intestinal transplant coordinator if anything seems wrong.
• Shop for food and prepare meals.
• Run errands, fill prescriptions, and do chores around the house.
• Provide support, encouragement, and entertainment.
• Keep your loved ones informed of your needs and wishes.

You can have one person or a team of people to help care for you during the intestinal transplant process.

Caregivers can be your:

• Spouse
• Brother or sister
• Children
• Friends
• Neighbors

To explore the possibility of intestinal transplantation for your child, please contact the Intestinal Care and Rehabilitation Program at Children’s Hospital of Pittsburgh of UPMC at 412-692-6110.