Transplantation Program

UI Health is a worldwide leader in medical and surgical treatment of disorders and disease of the small bowel and intestines. Our comprehensive team of gastroenterologists, transplant surgeons, nurses, dietitians, pharmacists, social workers, and psychologists works to ensure the best possible patient care, from diagnostic procedures to intestinal rehabilitation and small bowel transplantation.

What is Intestinal Failure?

Intestinal failure is the inability to meet the nutritional and/or fluid requirements in order to maintain nutritional independence necessary for growth and development in children, and maintenance of a normal life in adults. Intestinal failure may result from congenital abnormalities, or as a complication from either a poorly functioning intestine, such as chronic idiopathic intestinal pseudo-obstruction syndrome, or a surgically resected intestine.

Complications of intestinal failure can include:

• Malnutrition
• Dehydration
• Vitamin, electrolyte, and mineral deficiencies
• Liver disease
• Blood infections
• Gallstones
• Osteoporosis
• Kidney damage
• D-lactic acidosis
• Blood clots

Individuals with intestinal failure require parenteral nutrition (PN), where they receive all or most of their nutrients and calories intravenously. PN is administered through a catheter placed in the arm, groin, neck or chest. Patients on PN may live for many years, but long-term use of PN can result in serious complications, such as bone disorders, central venous catheter-infections, and liver disease. In fact, every organ system of the body may be affected. If those complications become life-threatening, an intestinal transplant may be required.

What Causes Intestinal Failure?

The causes of intestinal failure are very much age-dependent.

Causes of intestinal failure in children can include:

• Congenital malformations, such as small bowel gastroschisis (born with the intestines outside of the body); atresia (born with narrowed or obstructed intestines); and Hirschprung disease (absence of nerve cells that stimulate contraction for proper function).
• Short bowel syndrome following extensive bowel surgeries to repair (severe twisting of the intestine (midgut volvulus) or life threatening intestinal inflammation (necrotizing enterocolitis, or NEC)
• Disorders that inhibit absorption, such as microvillus inclusion disease and chronic intestinal pseudo-obstruction  

Causes of intestinal failure in adults can include:

• Short bowel syndrome following extensive surgeries
• Twisting of the intestine (volvulus)
• Inflammatory bowel disease, such as Crohn's disease or Colitis
• Small bowel tumors (Gardner's syndrome)
• Soft tissue tumors occurring in the abdominal wall, mesentery, or retroperitoneum (Desmoid tumors)
• Disorders associated with mobility/contraction or malabsorption of nutrients, such as chronic intestinal pseudo-obstruction, scleroderma, and radiation-damaged bowel

Intestinal Failure Management & Intestinal Rehabilitation

Malabsorption conditions like short bowel syndrome and long-term parenteral nutrition can result in complications like liver disease and recurrent infection. Our doctors specialize in medical, surgical, and rehabilitation treatments to prevent and manage life-threatening complications, should they occur.

Intestinal failure management and rehabilitation includes:

• Special diets
• Fluid management with oral rehydration treatment and diarrheal control
• Vitamin, mineral, and electrolyte supplements
• Hormonal therapy
• Stoma care and ostomy care
• Non-transplant intestinal surgery, including fistula repair
• Surgical treatments, including re-establishment of colonic continuity; gut-lengthening surgery, including Bianchi and STEP procedures; and intestinal transplant.
• Transplant