When Is Intestinal Transplant Necessary?

Intestinal transplants, or short bowel transplants, are performed to replace diseased intestines with healthy ones. A part of the small intestine can be transplanted into a child. If needed, other organs can be transplanted at the same time.

When children suffer from advanced intestinal disease, they need to be given nutrition through their veins. This is called total parenteral nutrition (TPN). But TPN can cause serious problems if it needs to be done for a long period of time. Extended administration of TPN can cause the following problems:

• Children may develop severe liver problems.
• TPN must be given in a very large vein. TPN can damage these large veins. There are only six veins large enough to use. If all are damaged, there is no way to feed the child.
• Putting TPN into the large vein can cause serious infections.

When any of these problems occur, doctors must consider an intestinal transplant.

The Demand for Intestinal Transplants

According to the Scientific Registry of Transplant Recipients, in 2019:

• 81 intestinal transplants — with almost equal numbers of intestine and intestine-liver transplants — were performed in the United States. 32 were pediatric recipients and 49 were adult recipients.
• Among the 349 patients on the waiting list at the time, 188 (53.9%) were waiting for intestine and 161 (46.1%) for intestine-liver transplant.
• 59% of candidates on the intestine waiting list were aged younger than 18 years, and adults accounted for 41%.