Intestinal and Multivisceral Transplant | Long-Term Outlook

What is the long-term outlook following an intestinal transplant?

Following the surgery, the Intestinal and Multivisceral transplant team will see your child for follow-up appointments to monitor their health, change medications if needed and stay in touch with your family. These visits will be frequent at first and gradually become less often. Eventually, your child may only need to come in once or twice a year.

Due to advances in surgery, better immunosuppressive medications and a decrease in life-threatening infections, one-year survival after intestinal or multivisceral transplant can approach 80 to 90 percent for children treated in experienced centers.

Data on long-term outcomes as reported in the “OPTN/SRTR 2016 Annual Data Report: Intestine” indicate patient survival of 67.7 percent at 5 years for recipients younger than 18 years of age. It is clear that intestinal or multivisceral transplantation has become a viable treatment option for permanent intestinal failure. Results will continue to improve as researchers at Boston Children’s Hospital and elsewhere discover new approaches to treating intestinal failure.

Medication adherence

After transplant, medications must be given for the rest of the child's life to fight rejection. The anti-rejection medication used with most intestinal and multivisceral transplant patients is tacrolimus.

Anti-rejection medications work by suppressing the immune system, but that means your child will be at higher risk for infections, especially those that have been lying dormant in his system. Our team will continually monitor your child’s health through blood tests and other exams, and medication dosages may change frequently.

Nutrition

Following transplant, your child will continue to receive total parenteral nutrition (TPN) until their new organs are functioning well enough to absorb nutrients. The goal is usually to have the child begin to drink and later on to eat as early as the first or second week after the transplant operation.

Growth and development following intestinal or multivisceral transplant

A transplant offers a chance for independence and better quality of life. Frequent medical supervision is still necessary after a transplant, but this need does decrease over time. It is critical to understand that transplantation is a treatment, not a cure. While a few precautions need to be taken, we encourage your child to live a full and happy life: go to school, play sports, spend time with friends and enjoy hobbies.