Small bowel transplant at the Center for Intestinal Care and Transplant
The Center for Intestinal Care and Transplant at MedStar Health, the only program in the nation's capital and one of only a few Medicare-approved centers nationwide, offers new and successful surgical and medical options for adults and children suffering from disabling and life-threatening intestinal disorders and liver disease. Once considered experimental, intestinal transplantation is now an important surgical therapy.
To learn more, please call 202-444-0766.
About the Center for Intestinal Care and Transplant at MedStar Health
Patients with small bowel disease may need to consider a small bowel transplant or intestinal surgery. In a small bowel transplant, the diseased portion of the small intestine is removed and replaced with a healthy small intestine from a donor. This procedure can be life-saving for patients with irreversible intestinal failure that has become life-threatening. Learn more about small bowel disease.
Why choose MedStar Health for your small bowel transplant?
The Center for Intestinal Care and Transplant at MedStar Health has been the largest volume small bowel transplant program in the world for more than 20 years. The MedStar Health small bowel transplant surgeons are highly experienced and have been performing these complex surgeries for more than 25 years. They are also leaders in cutting-edge research to advance the field of intestinal transplantation and develop new medical and surgical treatments for complex, life-threatening intestinal disorders.
The benefits of choosing MedStar Georgetown University Hospital include:
- Better outcomes: Our adult one-year survival rate is 87.84%, compared to 82.78% nationally. Pediatric one-year survival is 100%, in contrast to 87.61% nationally.
- Shorter wait times: On average, our patients’ time on the transplant waitlist is just 4.4 months, compared to 10.3 months regionally and 11.2 months nationally.
- Expertise: Our small bowel transplant team performs approximately 18% of all small bowel transplants in the U.S. and is the highest volume program in the nation and the world.
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Fast access: A transplant surgeon is on call 24 hours a day, seven days a week to evaluate organs for potential transplantation.
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Multidisciplinary care: Our team includes experienced surgeons, gastroenterologists, oncologists, and nurses who provide the highest quality, compassionate care.
Who is a candidate for a small bowel transplant?
Disease, trauma, and genetic disorders can cause intestinal damage and failure. As an active intestinal rehabilitation center, we offer both medical and surgical options to successfully treat the most complex intestinal failure cases to help patients avoid transplant.
If non-surgical approaches are no longer working or are not an appropriate treatment, small bowel transplantation can offer a lifesaving option, especially for patients with the most difficult-to-treat conditions, including:
- Acute and chronic portomesenteric thrombosis (blood clots in veins in the intestines)
- Complex enterocutaneous fistula (abnormal opening between the gastrointestinal tract and the skin)
- Congenital bowel anomalies (birth defects that affect the gastrointestinal tract)
- Embolic disease of the intestine (blood clot from elsewhere in the body blocks an artery supplying blood to the intestines)
- Gastrointestinal cancer
- Gastrointestinal motility disorders (conditions that affect the muscles in the gastrointestinal tract)
- Intestinal volvulus (twisting of the intestines)
- Malabsorption syndromes (conditions that cause the small intestines to not properly absorb nutrients)
- Mesenteric ischemia (reduced blood flow to the intestines caused by a blocked artery)
- Necrotizing enterocolitis (a condition that causes intestinal wall tissue to die)
- Crohn’s disease and inflammatory bowel disease that is not responding to treatment
- Short gut syndrome / intestinal failure (conditions where the small intestine can no longer absorb nutrients and fluids properly)
Small bowel transplant evaluation
The small bowel transplant team conducts a thorough evaluation of each patient to figure out whether they are eligible for a transplant. The evaluation process takes about three to five days and includes a review of the patient's medical history, a physical exam, and tests including bloodwork, imaging, and other tests. The dedicated intestinal transplant coordinator manages the entire pretransplant evaluation process, helping you schedule any needed appointments.
This information is used to create your profile and determine whether you’re a candidate for a transplant and where you’ll be placed on the national transplant waiting list if transplant is an option for you. After the evaluation, the team will meet to determine our recommended best treatment option and then work with you to follow the treatment path.
While you’re waiting for an organ, our team will be in constant communication with you and care for you so you’re in the best health possible when it comes time for your transplant.
Small bowel transplant process
During a small bowel transplant, the small intestine is surgically removed and replaced with a healthy organ from a deceased donor. The blood vessels of the patient and donor intestine are connected to provide a blood supply to the transplanted intestine. The donor intestine is then linked with the patient's gastrointestinal tract.
Ileostomy
During the surgery, an ileostomy is performed to allow body waste to pass directly out of the body and empty into a pouch. The procedure surgically creates an opening through which the ileum, a section of the small intestine, is brought up through the abdominal wall. In time, most patients are able to have the ileostomy closed.
Small bowel transplant recovery
After their transplant, most small bowel recipients spend several weeks in the hospital. During your time in the hospital, our specialists closely monitor you for signs of organ rejection, infection, or other complications. Your dedicated multidisciplinary care team will include:
- Surgeons
- Gastroenterologists
- Critical care physicians
- Radiologists
- Nurse practitioners
- Physician’s assistants
- Pharmacists
- Dietitians
- Pediatric specialists for young patients
- Financial coordinators
Our goal is to provide every patient with the full range or care and support needed throughout the transplant process and during life after transplant. Because intestinal transplant is complex and specialized follow-up is needed, we follow our patients for life, no matter where in the world they live.
Our providers
Expert transplant care
Getting the care you need starts with seeing one of our transplant specialists.Frequently asked questions
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What is intestinal failure?
Intestinal failure is the loss of the absorptive capacity of the small bowel. A common cause for children is short gut syndrome, a congenital disorder in which an infant's intestine is too short or underdeveloped to allow normal food digestion. Among other causes are abdominal trauma, Crohn's disease, thrombotic disorders, and surgical adhesions.
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What causes intestinal failure?
Intestinal failure can be caused by disease or by trauma, which affects how the intestine absorbs nutrients or moves food through the intestinal tract. If the intestine structure is damaged, or there is a problem with the blood supply to the intestine, a transplant may be necessary to repair the damage and restore proper functioning.
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What is small bowel transplant and how does it help the patient?
Small bowel transplant is the transplantation of an intestine to an individual with irreversible intestinal failure. The purpose of this transplant is to restore intestinal function. It is used to treat intestinal failure when other treatments, such as parenteral nutrition (intravenous tube feeding or TPN), are not successful.
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What are the survival rates for small bowel transplants?
The three-year survival rate for intestinal transplant patients is 70 percent and greater.
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How is small bowel transplantation performed?
Small bowel transplantation can be performed in one of three ways: alone, in combination with the liver or multi-visceral (i.e., with one or more of the following: liver, pancreas, stomach, duodenum, intestine, and colon).
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How can I qualify for small bowel transplantation?
The individual must have none of the following for any small bowel transplantation:
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Life expectancy of fewer than five years due to age-related debilitation and co-morbidities
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Ability to ingest oral nutrition
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Unresectable malignancy
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Serious, uncontrolled psychiatric illness that would hinder following directions with any stage of the transplant process
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Neurologic illness independent of the disease process being treated
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Drug or alcohol addiction
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HIV (positive)
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Active and/or life-threatening infection
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Severe body/organ system disease unrelated to transplanted organ
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Compromised cardio-pulmonary function unrelated to transplanted organ
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Inability or unwillingness of the individual or legal guardian to give signed consent and to comply with regular follow-up requirements
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Patient stories
Additional information
Click here to learn about the small bowel transplantation support group.
How can I qualify for small bowel transplantation?
Our goal is to provide you with all the information you need to undergo a healthy small bowel transplantation process. Our program is based on the patient's physical, emotional, and spiritual needs and welcomes the active participation of family members throughout the transplant process.
Transplant clinic lab hours
Monday: 7:30 a.m. to 4 p.m.
Tuesday: 7:30 a.m. to 4 p.m.
Wednesday: 9 a.m. to 6 p.m.
Thursday: 7:30 a.m. to 4 p.m.
Friday: 7 a.m. to 3:30 p.m.
Patient resources
Research & clinical trials
Research is a critical part of what we do at MedStar Health. Learn more about our research on treating and managing advanced disease and transplantation surgery.
Keeping your organ healthy
The transplant process is a long and complicated one. Now that your healthy small bowel is functioning inside your body, you must assume responsibility for your everyday care.