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Intestine transplantation, also known as small bowel transplantation, is a surgical procedure wherein one brings a healthy segment of small intestines from a deceased donor to replace the diseased segment in the body of a patient. It is typically performed in patients with failure of intestinal absorption and who are not receiving any benefits from the known parental or enteral supply.

An intestinal transplant is done to restore a damaged or failed small intestine, usually in people with intestinal failure who are unable to absorb nutrients effectively and are experiencing complications due to long-term total parenteral nutrition (TPN), for example, liver failure or ongoing bloodstream infections.

See a specialist if you or a child develops chronic intestinal failure, recurrent catheter-related infection, liver injury due to TPN, or intestinal motility disorders that conservative management cannot manage.

Preparation includes extensive evaluation, including blood tests, imaging, nutritional assessments, and psychological evaluations. You’ll be placed on a transplant waiting list and educated about risks, lifestyle changes, and post-op care. Vaccinations and infection screenings are typically updated.

The procedure involves removing the ill intestine and surgically implanting a donor intestine. In certain situations, other organs (such as the liver or pancreas) are transplanted at the same time. The operation is performed under general anesthesia and can last 8 to 12 hours, depending on the complexity and number of organs.

The process can take 8 to 12 hours, and then an extended stay in the ICU for observation. Complete hospitalisation can take several weeks to deal with the risk of rejection, infections, and stabilising nutrition.

Organ rejection
Infections
Graft-versus-host disease
Bleeding
Complications from immunosuppressants

For individuals with irreversible intestinal failure, the transplant will restore independence from nutrition, decrease reliance on TPN, and enhance quality of life and survival. It's particularly priceless when complications arising from TPN are life-threatening.

Recovery is also intensive, with frequent monitoring, rejection detection biopsies, and lifelong immunosuppression therapy. The patients are transitioned slowly over weeks to months to oral or enteral feeds and require long-term follow-up by a transplant team.

One-year survival is about 80%, and five-year survival is about 60–70%, although it depends on age, condition, and transplant type (isolated vs. multivisceral).