Description of Treatment/Procedure

Small bowel transplant can involve grafting a section of bowel only or, if there is liver failure, a combined bowel/liver transplant may be performed. It is used to treat short bowel syndrome (SBS), a condition that may affect children or adults. Early attempts were largely unsuccessful due to graft rejection and graft versus host disease. The use of new immunosuppressive agents has produced greater success in recent years.

Committee Summary

The ICSI Technology Assessment Committee finds small bowel transplant and combined liver-small bowel transplant to be clinically effective for selected patients with SBS with and without end-stage liver disease. Clinical experience suggests that small bowel transplant and combined liver-small bowel transplant are clinical options that should be reserved for patients whose intestinal failure is irreversible and when life threatening complications of TPN become unmanageable.