Bowel transplant - What happens before having a small bowel transplant

If you are being considered for a small bowel transplant, you will be referred for a transplant assessment. Tests will be carried out to see whether a transplant is the best treatment for you.

Transplant assessment

An in-depth assessment will need to be carried out before deciding whether you should be placed on the waiting list for a transplant.

This will usually involve a number of different tests carried out over a period of one to three weeks. Depending on your overall health, you may need to stay in hospital while these tests are carried out, or you may only need to attend a series of outpatient appointments.

Tests you may have include:

  • blood tests ‐ to check your liver function, electrolytes, kidney function and to see if you have any serious infections, such as HIV or hepatitis
  • a number of scans ‐ such as a chest X-ray, a computerised tomography (CT) scan of your tummy (abdomen) and an ultrasound scan of your liver
  • an endoscopy ‐ where a long, thin tube with a camera on the end is inserted into your rectum to examine the inside of your bowel
  • lung function tests

During the assessment, you will have the chance to meet members of the transplant team and ask questions. The transplant co-ordinator (the person organising your transplant, who you will have most contact with) will talk to you and your family about what happens, and the risks involved in a small bowel transplant.

When the assessment is complete, a decision will be made on whether a small bowel transplant is the best option for you.

Why you might be unsuitable for a transplant

Not everyone considered for a small bowel transplant is suitable. For example, it may be unsuitable for you because:

  • you have cancer that has spread to several areas of your body
  • you have a serious illness with a very poor outlook
  • you require breathing support with a ventilator (a machine that moves oxygen-enriched air in and out of your lungs)
  • you are over 60 years of age
  • you haven't acted on your doctor's advice (to quit smoking, for example), haven't taken the medication prescribed for you or have missed hospital appointments

Waiting for a transplant

If you are felt to be suitable for a small bowel transplant and are unable to receive a living donation from a family member, you will be placed on the national waiting list.

If you are on the waiting list, the transplant centre will need to contact you at short notice as soon as organs become available for transplantation, so you must inform staff if there are any changes to your contact details.

You will usually be contacted before the transplant surgeons have had a chance to assess the suitability of the donated organs, which means there is a chance you may be called in several times for "false alarms" before the operation is eventually carried out.

The length of time you wait will depend on your blood group, donor availability and how many other patients are on the list (and how urgent their cases are). On average, people wait just under six months for a small bowel transplant.

While you wait, you will be cared for by the doctor who referred you to the transplant centre. Your doctor will keep the transplant team updated about changes to your condition. Another assessment is sometimes necessary to make sure you are still suitable for a transplant.

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