Transplantation of the intestine is a procedure performed
regularly at a few specialized transplant centers in the USA
and world. As one of the world’s leaders in solid organ
transplantation,
the University of California, Los Angeles (UCLA) was one of
the first centers to establish a program of intestinal
transplantation. This program grew from the already
established, successful, and busy liver transplant program
in an effort to meet the needs of a unique set of patients
with short bowel syndrome (SBS or short gut syndrome (SGS)),
dependence on total parenteral nutrition (TPN), and advanced
liver disease. Established in 1991, this program has grown
steadily over the past decade under the guidance of Dr
Douglas G. Farmer. The Dumont-UCLA Intestinal Transplant
Program is one of the largest of its kind in the world
offering transplantation of the intestine alone, liver and
intestine, and multivisceral combinations to appropriate
adult and pediatric candidate needs.
One of the true strengths of the program is the
multidisciplinary approach taken for each patient referred
for evaluation. This program operates under the larger UCLA
Intestinal Failure Center. An experienced team consisting of
specialists in transplantation surgery, gastroenterology,
hepatology, cardiology, pulmonology, nephrology, nutrition,
social work, and psychiatry routinely evaluate the unique
needs of this patient population. Intestinal function is
carefully assessed based on length, location, and function
of remnant intestine. For patients with intestinal failure,
the appropriate transplant involving the intestine is
recommended. However, intestinal transplantation is not
appropriate for all patients and any of a number of medical
and/or surgical treatment options can be offered and
administered as indicated including intestinal lengthening
procedures, restoration of intestinal continuity, and
intestinal anastomosis/resections. When appropriate,
patients benefit from a long-term, careful follow-up by the
multidisciplinary team resulting in optimal care and
incorporating changes in the condition of the patient over
time.
This approach has resulted in continued success over the
past decade. Recipients of intestinal transplants at UCLA
enjoy one of the highest survival rates in the world.
Furthermore, clinical experience, preemptive and prophylaxis
therapies have led to reduced rates of rejection and viral
infections after transplantation. Successful transplantation
leads to independence from TPN and reliance solely on
enteral/oral nutrition to meet caloric needs.
Consults are available for intestinal transplant
evaluation as well as to assist with the medical and
surgical management of patients with difficult
gastrointestinal conditions, short bowel syndrome, TPN-dependence,
and liver disease. Information concerning the Intestinal
Transplant Program at the Dumont-UCLA Transplant Center or
concerning intestinal transplantation in general, can be
obtained by writing or calling the central offices.
