Intestine

Indication for Transplant

Criteria have been established to help determine if a patient is a candidate for transplantation. The criteria explain the reasons for inclusion in, or exclusion from intestine transplantation.

Inclusion

In addition to one of the following, criteria for intestinal transplantation include but are not limited to dependence on Total Parenteral Nutrition (TPN):

  • Liver dysfunction or failure secondary to TPN
  • Limited veins for TPN (clots in two of six major veins used for TPN)
  • Life-threatening central line infections (Intravenous lines used for TPN)
  • Repeated central line infections
  • Repeated episodes of dehydration
  • Extremely short gut

Patients may also be considered for intestinal transplantation if they have a small intestine that has been severely damaged, cannot be reconstructed and intestinal rehabilitation is not an option.

Other criteria include:

  • Patients must quality for and be able to tolerate major surgery
  • Patients and their family members/support system must be able to understand the risks and benefits of transplantation, including the long-term need for close medical follow-up and life-long need for anti-rejection medications
  • Patients/families must be able to accept the responsibility to be involved in the long-term care required after transplantation, including the financial responsibilities

Exclusion

Factors and considerations that may result in exclusion from transplantation include:

  • The presence of some other life-threatening disease or condition that would not improve with transplantation. This would include certain cancers, infections that cannot be treated or cured or significant brain injury/damage that is not thought to be irreversible.
  • History of chronic non-compliance including, but not limited to, medical treatments, medications or other behaviors that would affect the patients' ability to fully care for themselves after transplantation.
  • History of chronic and ongoing drug and/or alcohol abuse that cannot be successfully treated before transplantation, putting patients at risk for continued harmful behavior after transplantation.
  • History of serious psychiatric disorders that cannot be successfully treated before transplantation, and that would be considered a high risk for ongoing or increased severity of the psychiatric disorder after transplantation.
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