Intestinal or Multivisceral Transplant in Children | Testing & Diagnosis

If it seems like an intestinal transplant might be an option for your child, we’ll ask you to come to the hospital for an informational visit. Your family will meet our team, and you’ll be invited to ask questions and share any concerns you may have. We encourage you to bring family members to this meeting.

If you and the transplant team agree that a transplant is the best option, your child will be scheduled for an evaluation, which is usually completed over the course of two to three days. This may sound like a lot, but it’s necessary so that we can:

  • confirm that a transplant is the appropriate treatment
  • determine how urgent the need for a transplant is
  • perform necessary diagnostic studies to know what type of transplant your child needs

Since a transplant is a complex procedure that involves many medical specialties, your family will meet our experts from a number of different areas, including:

  1. Transplant surgeon: doctor who performs the actual transplantation procedure.

  2. Transplant gastroenterologist: doctor who specializes in the diagnosis and treatment of transplanted intestinal diseases.

  3. Transplant coordinator: advanced practice nurse with special training in caring for intestine and multivisceral transplant patients. She will organize all aspects of your child’s care before and after the transplant.

  4. Anesthesia: The anesthesiologist will review your child's medical and/or surgical histories, identify any risk factors associated with anesthesia and plan the type of anesthesia that will be specifically tailored to your child.

  5. Infectious disease: Our infectious disease specialist will perform a physical exam and review your child's vaccination records. We will want to know if your child has any particular environmental exposures or has recently traveled to a foreign country.

  6. Psychiatry: A psychiatrist or psychologist will meet with you and your child to discuss coping strategies, stress management and family life.

  7. Child Life specialist: trained professional who uses play and other activities to help children understand and adjust to their hospital experience.

  8. Social services: Our transplant social worker will meet with you and your family to identify support systems and discuss your feelings about transplant. We can provide you with information about resources related to finances, transportation, relocation expenses and support groups.

  9. Nutrition: Our registered dietician will evaluate your child's diet and nutritional requirements. It’s important that your child maintain a healthy lifestyle and good nutrition before the transplant.

  10. Physical therapy: The physical therapist will discuss the importance of exercising before transplant in a way that is appropriate for your child. The goal of developing an exercise plan is to help increase endurance and strength.

  11. Dentist: Before a transplant can be considered, we often recommend that your child meet with his own dentist or one here at the hospital. The goal is to treat any cavities, infections or tooth abscesses before the operation, since these conditions can be problematic once your child begins to take medicine to suppress his immune system.

  12. If your child has any other medical problems such as a lung condition (e.g. asthma or cystic fibrosis) or heart disease, other specialists may be included to fully assess your child’s condition.

What tests are used during the evaluation?

Your child’s specialists will order different tests to rule out infections and see how well your child’s organs are functioning. These types of tests may include:

  • blood tests to determine blood type (an organ donor and recipient must have compatible blood) and assess the function of the liver, lungs and other vital organs
  • tests to determine if your child has antibodies to viruses that can become activated after transplant
  • abdominal ultrasound to allows doctors to see the liver and flow of blood through arteries and veins
  • barium enema, an x-ray study in which a small tube filled with barium is inserted into your child's rectum and large intestine in order to evaluate her anatomy
  • chest x-ray to see if your child's lungs are healthy
  • electrocardiogram (EKG) and echocardiogram to evaluate your child's heart
  • D-Xylose absorption test to measure the intestines' ability to absorb nutrients
  • gastric emptying study to help detect gastroesophageal reflux and measure gastric emptying time
  • upper gastrointestinal (GI) tract and small bowel follow through to check your child's intestinal length and rule out obstruction. The procedure is a type of x-ray in which your child drinks (or it can be administered via a G-tube) a substance called barium, which coats the intestine.

After these consultations and tests, our transplant team will meet as a group to determine whether your child is a good candidate for a transplant. Our multidisciplinary approach to care ensures that your child’s case will be given thoughtful discussion of every treatment possibility.

If your child is a transplant candidate, we’ll make sure your family is fully educated about the risks and benefits, and your child will be placed on the United Network for Organ Sharing (UNOS) waiting list.