Which Children Need an Intestinal Transplant?

Candidates for intestinal transplantation (also known as pediatric small bowel transplant) include children who suffer from permanent intestinal failure due to short bowel syndrome (surgical removal of most of the small intestine), congenital incurable abnormalities of the intestine, or life-threatening complications of total parenteral nutrition (TPN). If severe, irreversible liver disease is also present, the child may be a candidate for combined small intestine-liver transplantation performed in conjunction with the Pediatric Liver Transplant Program.
 
Indications for intestinal transplantation may include:

• Surgical short bowel syndrome due to 
  • Volvulus
  • Gastroschisis
  • Necrotizing enterocolitis (NEC)
  • Hirschsprung’s disease (also know as aganglionosis)
  • Injury (trauma)
  • Other problems or conditions resulting in short bowel syndrome
• Congenital intestinal atresia
• Poor intestinal absorption
  • Autoimmune disorders
  • Brush border element assembly problems
  • Microvillus inclusion disease
• Severe disorders of motility resulting from intestinal pseudo-obstruction (congenital or acquired)
• Tumors
  • Gardner’s disease (intestinal polyposis)
  • Desmoid tumors
• Serious complications of TPN therapy
  • Thrombosis (blockage due to a blood clot) of two or more major central veins (subclavian, jugular, femoral)
  • Repeated episodes of line sepsis or line infections

The decision to proceed with intestinal transplantation is made only after careful evaluation determines that the surgery is the child’s most promising treatment option.