Small Bowel Transplantation

Small Bowel Transplantation

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Overview

The first small bowel transplantation in Kerala was performed in Amrita Institute of Medical Sciences on 05th January 2015.
A small bowel (intestinal) transplant is an operation to replace a diseased or shortened small bowel with a healthy bowel from a donor. 

In the small intestine much of the digestion and absorption of food takes place. The primary function of the small intestine is the absorption of nutrients and minerals from food.

Features

Why small bowel transplants are carried out?

A small bowel transplant is an option for children and adults whose bowel has stopped working properly and who are being fed by total parenteral nutrition (TPN). This is where a person requires all their nutrition to be given through a drip into a vein because their bowel is unable to absorb nutrients from any food they eat.

Intestinal Failure

Some persons are born with or develop irreversible intestinal failure. Intestinal failure occurs when a person's intestines can't digest food and absorb the fluids, electrolytes and nutrients essential to life and normal development. Patients must then receive TPN, which provides liquid nutrition through a catheter or needle inserted into a vein in the arm, groin, neck or chest.

Total Parenteral Nutrition (TPN)

Patients with intestinal failure may receive all or most of their nutrients and calories intravenously through total parenteral nutrition, or TPN. TPN is given through a catheter placed in the arm, groin, neck or chest. Patients on TPN may live for many years, but long-term use of TPN can result in serious complications, such as bone disorders, central venous catheter infections and liver disease. If those complications become life-threatening, an intestinal transplant may be required.

Causes of Intestinal Failure

The most common cause of intestinal failure is short bowel syndrome where at least half or more of the small intestine has been removed. Short bowel syndrome is typically a postsurgical condition for treatment of conditions such as trauma or necrotizing enterocolitis.
Intestinal failure may also be caused by functional disorders such as Crohn's disease, a digestive disorder, or chronic idiopathic intestinal pseudo-obstruction syndrome.

Pediatric Conditions Causing Intestinal Failure

Congenital malformations such as small bowel atresia, gastroschisis, aganglionosis Infections of the gastrointestinal tract such as necrotizing enterocolitis) Short bowel syndrome following extensive bowel surgeries secondary to mesenteric ischemia (e.g., midgut volvulus) Absorptive impairment (e.g., intestinal pseudo-obstruction, microvillus inclusion disease)

Adult Conditions Causing Intestinal Failure

  • Short bowel syndrome following extensive surgeries secondary to mesenteric ischemia (following thrombosis, embolism, volvulus, or trauma)
  • Inflammatory bowel disease such as Crohn's disease
  • Small bowel tumors such as Gardner's syndrome (familial colorectal polyposis)
  • Tumors of the mesenteric root and retroperitoneum (desmoid tumor)

Specialty

Types of Intestinal Transplants

There are three major types of intestinal transplants that are described in detail below.

  • Isolated intestinal (Small Bowel) Transplantation:
    In an isolated intestinal transplant, the diseased portion of the small intestine is removed and replaced with a healthy small intestine from a donor. This procedure can be lifesaving for patients with irreversible intestinal failure that has become life-threatening.
  • Combined Liver and Intestinal Transplantation:
    Combined liver and intestine transplantation is done for patients with both liver and intestinal failure. In this procedure, the diseased liver and intestine are removed and replaced with a healthy liver and intestine from an organ donor.
  • Multivisceral Transplantation :
    Multivisceral transplantation is performed where two or more intra-abdominal organs (including the intestines) are failing. The transplanted organs may include the stomach, duodenum, pancreas, intestine, and liver for patients with diseases such as Gardner's syndrome (familial colorectal polyposis), a pre-malignant colorectal condition and intestinal pseudo-obstruction (decreased ability of the intestines to push food through).

Contact Us

Phone: +91 9400998074 (08:30 to 17:30)

Email: livertransplant@aims.amrita.edu, gisurgery@aims.amrita.edu

Doctors

Dr. Krishnanunni Nair
Clinical Associate Professor
MBBS, MS (General Surgery), MCh (Surgical Gastroenterology)
Dr. Sudheer O V
Clinical Professor and Head
MS (General Surgery), MCh (Gastrointestinal Surgery)
Dr. S. Sudhindran
Clinical Professor and Chief Transplant Surgeon
MS (General Surgery), FRCS (Glasgow), FRCS (Eng.), FRCS (General Surgery)
Dr. Unnikrishnan G
Clinical Associate Professor
Dr. Shweta Mallick
Associate Professor
MBBS, MS, MCh
Dr. Binoj S T
Clinical Professor
MS (General Surgery), DNB (Surgical Gastroenterology), Fellowship in Minimal Access Surgery

Overview

The first small bowel transplantation in Kerala was performed in Amrita Institute of Medical Sciences on 05th January 2015.
A small bowel (intestinal) transplant is an operation to replace a diseased or shortened small bowel with a healthy bowel from a donor. 

In the small intestine much of the digestion and absorption of food takes place. The primary function of the small intestine is the absorption of nutrients and minerals from food.

Features

Why small bowel transplants are carried out?

A small bowel transplant is an option for children and adults whose bowel has stopped working properly and who are being fed by total parenteral nutrition (TPN). This is where a person requires all their nutrition to be given through a drip into a vein because their bowel is unable to absorb nutrients from any food they eat.

Intestinal Failure

Some persons are born with or develop irreversible intestinal failure. Intestinal failure occurs when a person's intestines can't digest food and absorb the fluids, electrolytes and nutrients essential to life and normal development. Patients must then receive TPN, which provides liquid nutrition through a catheter or needle inserted into a vein in the arm, groin, neck or chest.

Total Parenteral Nutrition (TPN)

Patients with intestinal failure may receive all or most of their nutrients and calories intravenously through total parenteral nutrition, or TPN. TPN is given through a catheter placed in the arm, groin, neck or chest. Patients on TPN may live for many years, but long-term use of TPN can result in serious complications, such as bone disorders, central venous catheter infections and liver disease. If those complications become life-threatening, an intestinal transplant may be required.

Causes of Intestinal Failure

The most common cause of intestinal failure is short bowel syndrome where at least half or more of the small intestine has been removed. Short bowel syndrome is typically a postsurgical condition for treatment of conditions such as trauma or necrotizing enterocolitis.
Intestinal failure may also be caused by functional disorders such as Crohn's disease, a digestive disorder, or chronic idiopathic intestinal pseudo-obstruction syndrome.

Pediatric Conditions Causing Intestinal Failure

Congenital malformations such as small bowel atresia, gastroschisis, aganglionosis Infections of the gastrointestinal tract such as necrotizing enterocolitis) Short bowel syndrome following extensive bowel surgeries secondary to mesenteric ischemia (e.g., midgut volvulus) Absorptive impairment (e.g., intestinal pseudo-obstruction, microvillus inclusion disease)

Adult Conditions Causing Intestinal Failure

  • Short bowel syndrome following extensive surgeries secondary to mesenteric ischemia (following thrombosis, embolism, volvulus, or trauma)
  • Inflammatory bowel disease such as Crohn's disease
  • Small bowel tumors such as Gardner's syndrome (familial colorectal polyposis)
  • Tumors of the mesenteric root and retroperitoneum (desmoid tumor)

Specialty

Types of Intestinal Transplants

There are three major types of intestinal transplants that are described in detail below.

  • Isolated intestinal (Small Bowel) Transplantation:
    In an isolated intestinal transplant, the diseased portion of the small intestine is removed and replaced with a healthy small intestine from a donor. This procedure can be lifesaving for patients with irreversible intestinal failure that has become life-threatening.
  • Combined Liver and Intestinal Transplantation:
    Combined liver and intestine transplantation is done for patients with both liver and intestinal failure. In this procedure, the diseased liver and intestine are removed and replaced with a healthy liver and intestine from an organ donor.
  • Multivisceral Transplantation :
    Multivisceral transplantation is performed where two or more intra-abdominal organs (including the intestines) are failing. The transplanted organs may include the stomach, duodenum, pancreas, intestine, and liver for patients with diseases such as Gardner's syndrome (familial colorectal polyposis), a pre-malignant colorectal condition and intestinal pseudo-obstruction (decreased ability of the intestines to push food through).

Contact Us

Phone: +91 9400998074 (08:30 to 17:30)

Email: livertransplant@aims.amrita.edu, gisurgery@aims.amrita.edu

Doctors

Dr. Krishnanunni Nair
Clinical Associate Professor
MBBS, MS (General Surgery), MCh (Surgical Gastroenterology)
Dr. Sudheer O V
Clinical Professor and Head
MS (General Surgery), MCh (Gastrointestinal Surgery)
Dr. S. Sudhindran
Clinical Professor and Chief Transplant Surgeon
MS (General Surgery), FRCS (Glasgow), FRCS (Eng.), FRCS (General Surgery)
Dr. Unnikrishnan G
Clinical Associate Professor
Dr. Shweta Mallick
Associate Professor
MBBS, MS, MCh
Dr. Binoj S T
Clinical Professor
MS (General Surgery), DNB (Surgical Gastroenterology), Fellowship in Minimal Access Surgery