Short Gut Syndrome Patient, Family & Professional Support Groups

Q: Will I or my child need an intestinal transplant?

In the past, infections, liver disease, and blood clots made it challenging to keep a patient healthy long enough to wean off of TPN. As a result, intestinal transplants were more common.

However, doctors have gotten better at preventing infection and caring for liver health. They also understand more about how to use diet, medicine, and surgical treatments to help the intestine adapt. Revolutionary new medications called GLP-2's are dramatically changing the treatment of SBS by speeding intestinal adaptation. 1

Intestinal rehabilitation programs (IRP's) employ a team of experts who specialize in intestinal care. They use these methods to help patients adapt so they can get needed nutrition without TPN or transplant. Although these programs are few, they are very effective. 2 Many patients travel to access care.

It is worth noting that most good intestinal transplant programs offer IRP, and most IRP programs also offer transplant. The goal is to use rehabilitation to avoid transplant as often as possible. 3

Referral for an intestinal transplant evaluation can be a foot in the door to skilled intestinal care, especially as it may be easier to get insurance preauthorization than seeking it for IRP alone. However, this referral does not mean that you need a transplant. It is simply an avenue to better care. 3


References

  1. Cohran VC, Prozialeck JD, Cole CR. Redefining short bowel syndrome in the 21st century. Pediatr Res. 2017 Apr;81(4):540-549. doi: 10.1038/pr.2016.265. Epub 2016 Dec 20. PMID: 27997531.
  2. Stanger JD, Oliveira C, Blackmore C, Avitzur Y, Wales PW. The impact of multi-disciplinary intestinal rehabilitation programs on the outcome of pediatric patients with intestinal failure: a systematic review and meta-analysis. J Pediatr Surg. 2013 May;48(5):983-92. doi: 10.1016/j.jpedsurg.2013.02.070. PMID: 23701771.
  3. Kaufman SS, Avitzur Y, Beath SV, Ceulemans LJ, Gondolesi GE, Mazariegos GV, Pironi L. New Insights Into the Indications for Intestinal Transplantation: Consensus in the Year 2019. Transplantation. 2020 May;104(5):937-946. doi: 10.1097/TP.0000000000003065. PMID: 31815899; PMCID: PMC8384045.





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