Intestine transplant is a surgical replacement of the small intestine for chronic and acute cases of intestinal failure. It may also require small bowel transplantation. While alternative treatments such as parenteral nutrition (PN) can also treat intestinal failure, transplanting can be done by complicated conditions such as liver disease associated with PN and short bowel syndrome. Intestinal transplants are also the most complex intra abdominal organ transplants, the least commonly performed. In the past decades, however, the outcome of bowel transplantation has improved tremendously and is still increasing annually.
Surgery for stomach
Stomach transplant surgery is of various types, the sort that best suits you depends on your disease’s severity.
Isolated intestine transplant (Small bowel)
- Individuals suffering from organ failure specifically dealing with the small intestine and not the liver should opt for an isolated intestine transplant as it aims to treat only the small intestine.
- Those with lifelong intestinal defects cannot digest food or have problems following a normal diet. They may find it hard to eat normal food or follow a normal diet followed by people of that region.
- Short bowel syndrome is an expression of dysfunctional intestines not able to consume nutrients adequately. When SBS happens with other Central Line complications, such as skepticism or failure to properly maintain a central line from other complications, for instance, clotting, intestinal transplant is considered.
Combined transplant of liver and intestine
- People with liver and intestinal insufficiency must go for this transplant.
- Much of the people with total parenteral nutrition, TPN without other treatment and have under 12 months of average survival.
- The stomach, duodenum, pancreas, and intestine are included in a multivisceral transplant (with or without the liver).
- Persons with gastrointestinal disorders that cause intestinal failure or life-threats will be recommended by the doctor to undergo multiv-isceral transplant.
- If your intestine and two or more intra abdominal organs fail, you may need this sort of switch.
- The multi-visceral complications of a transplant may include dietary issues (food tubes or alternate methods of correct nutrition may be required), or rejection of the transplanted organ that is avoided by taking medication against rejection for the rest of your life. The side effects of these drugs may also complicate the role of your immune system.
Reasons for Multivisceral Transplantation
It is important to understand the key reason for intestinal transplantations before addressing the causes of multivisceral transplantation. Intestinal transplantation is more common than multivisceral transplantation. In the general case of people with short bowel syndrome, intestinal transplants are performed by:
- Congenital (rare) anomaly: genetic abnormality at birth.
- Gastroschisis: intestine is in some other path than the original path
- Blockage of intestines: intestinal atresia
- Midgut volvulus: twisted intestines that cause blockage
- A bacterial infection which destroys the intestinal walls, mostly in premature infants;
- Disorders in motility
When is a transplant necessary?
These requirements are usually measured to decide transplant necessity:
- Nutrition deficiency at home
- Increased death risk
- Lower than 10 cm small intestine in children, or less than 20 cm small intestine in adults
- Increased urgency and need to be hospitalized, based on drugs or pseudo-bowel obstruction (symptoms similar to an obstructed bowel without actually being obstructed)
- Not ready or unable to keep parental food at home for longer periods.
A series of tests and scans will be carried out to determine your risks and benefits from the operation. Due to the many possibilities for intestinal transplantation, tests and scans vary by person. Some bowel failure tests may include:
- Head, chest, and abdominal CT scans
- Stress test
- Blood test
- Catheterization of the heart
- Testing of lung function
- Endoscopic treatment
- Studies of motility
- X-rays upper GI rays and small intestines\
Who should undergo a stomach transplant surgery?
- An ongoing disease
- Certain cancer types
- Organ failure of multi-system
- Oedemaanother structural element in the brain
- HIV in advance
Surgery for stomach cancer
Surgery is often included in the treatment of gastrointestinal cancer if done. Operation (often together with other treatments) provides the best opportunity to try to cure cancer if this cancer did not extend to other areas. Two main reasons for the surgery are:
- Surgery to remove cancer: cancer affecting a part of or all the region of the abdomen can be removed, including some nearby lymph system and other structural elements, but it, however, depends on the location and stage (extent) of cancer. At times, other organs may also be required to be removed, but the surgeons usually try to leave as much portion of the organs as possible while operating.
- Palliative operation: if cancer becomes too rampant to be destroyed, surgery may still be done to support and prevent tumor bleeding. This type of operation can discourage or alleviate symptoms, but cancer may not be cured completely.
Surgery for stomach cancer
Various types of surgery may be used to try and eliminate cancer in the stomach. The surgery to be performed depends on the extent of the spread of cancer. The types of surgery for the removal of cancer are:
- Endoscopy resection
EMR and ESD are procedures that can be used to treat certain early-stage cancers if the tumor has not developed deep within the stomach and the risk of spreading outside the stomach is very low. The EMR and ESD cancer treatment are both intraocular.
- Subtotal gastrectomy (partial)
Only part of the stomach is removed during this operation. That is often suggested when the cancer is in the lower abdomen only (in which case it is known as a distal gastrectomy). This method may also be used to treat cancer which is only at the top of the stomach (in which case it is known as a proximal gastrectomy).
- Total pneumonia
This procedure is performed if cancer has spread widely in the abdomen. It is often also recommended if the cancer is close to the oesophagus at the top of the stomach.
If cancer reaches all of your belly, your nearby lymph nodes, and your omentum, your surgeon may remove the spleen and portions from your esophagus, intestine, pancreas and other nearby organs. Another part of the intestine is attached to the end of the esophagus. Food can be moved through the intestinal tract. However, a person who has gone through a stomach transplant surgery, may have very limited options of food to choose from.
Organ transplant procedure saves a life, but continuous surveillance and resistance medicines are required. You can survive without your stomach, but a stomach transplant operation is generally not an option unless there are other gastrointestinal organs too. The replacement of stomachs, intestines, pancreas, liver, and potentially kidneys is part of multivisceral transplantation. The treatment is complex, with a long time of recovery. However, multivisceral transplantation can be a rescue agent if other alternatives fail.