Surgical procedure to treat chronic intestinal failure. Small-bowel transplantation is considered for people who have intestinal failure and cannot tolerate tube feeding. Immunosuppressive drugs given after surgery increase the chances for a successful transplant and a return to normal eating. Serious risks include infection and organ rejection. Because of the risks, the procedure is performed less frequently than kidney, heart, or liver transplants.
This may be needed for patients who have lost so much of their intestines that they cannot digest and absorb food sufficiently well to survive. It is commonest in babies who have suffered acute abdominal conditions such as volvulus. Before the advent of small-bowel transplants, long-term intravenous feeding (total parenteral nutrition or TPN) was the last option for patients with chronic intestinal failure. Small-bowel transplantation is currently reserved for patients unable to continue on long-term parenteral nutrition. The main constraints to small-bowel transplantation are the intensity of rejection (necessitating high levels of immunosuppression), and the lack of donors who are the same size as the recipient (a particular problem for children).