Gastric transplantation is not often performed and is usually not a one-time operation. A stomach transplant is usually performed as part of a multi-organ transplant.
Read on to learn more about gastric transplant surgery, which organs are typically involved, and how the procedure works.
A stomach transplant is a surgical procedure to replace a diseased stomach with a healthy donor match from a deceased person. Gastric transplantation is usually not performed on its own, but in combination with other abdominal organs.
A multivisceral transplant is a procedure in which the following parts are replaced:
- stomach
- the pancreas
- lever
- small intestine and/or large intestine
- and possiblekidneys
With a modified multivisceral transplant you keep your own liver.
Stomach transplants are usually performed when other gastrointestinal organs are also diseased and there is no other way to treat them. Some reasons why your doctor may suggest a multivisceral transplant include:
- Cancer
- desmoïde tumormed intra-abdominal infiltration
- endocrine tumors
- gastroschisis
- vascular abdominal trauma
- various congenital abnormalities
With any organ transplant, you will need to take anti-rejection medications for the rest of your life. There are also a large number of possible complications.
There are many typesstomach problems, but a stomach transplant in itself is not medically necessary. That's because, no matter how hard it is to imagine, you can live without a stomach.
Some conditions, such asstomach cancerpartial or complete removal of the stomach may be necessary. If the cancer has not spread beyond the stomach, there is no need to remove other abdominal organs.
When the entire stomach is removed, it is called a totalgastrectomy. In this procedure, surgeons connect the esophagus to the small intestine. In some cases they will also make a small bag to hold some more food.
Either way, you still want a functioning digestive system. Gradually you will be able to introduce regular foods and within a few months you should be on a relatively normal diet. But big meals are a thing of the past. You will need to eat many smaller meals throughout the day.
The lead-up to an organ transplant is generally long. Much depends on the availability of healthy, compatible organs and the coordination of surgical teams on both sides.
The operation is complicated. Members of the surgical team may include:
- operating room nurses
- anesthetist
- gastroenterologist
- transplantatieskirurg
- transplant hepatologist (liver specialist)
- radiologist
Proceduretrin
The procedure takes approximately 8 to 12 hours and includes the following steps:
- INanesthesiais administered.
- A surgeon makes a long incision in the abdomen.
- The abdominal organs are examined for signs of infection or anything else that could interfere with a successful transplant.
- The organs that are replaced are removed.
- The surgical team implants the donor organs. Because multiple organs are involved, the surgical team will need to restore many vital connections, such as the flow of gastrointestinal contents, veins, and arteries.
- The surgeons ensure that all bleeding is under control.
- The incision is closed.
Depending on the details of your surgery, the surgeon may create onestoma. This allows solid waste to come out through an opening in your stomach. The waste is collected outside the body in a bag. This may be temporary.
Your recovery begins in intensive care (IC). You receiveintravenous (IV) fluids, nutrition and medicines. Monitoring equipment tracks vital functions such as heart rate, breathing and blood pressure.
You will have several drains at the incision site to help your body remove excess fluid from the surgery. They are only temporary.
Medicines you can take
Among the medications you may receive at this time are:
- Immunosuppressive.Thisanti-rejection medicationMake sure your immune system doesn't reject your new organs.
- Medicine against infections.These medicines help your weakened immune system fight infections.
- Painkillers or other medications.Additional medications may be given to treat the side effects of surgery or other medical conditions.
Depending on how well your recovery goes, you will stay in intensive care for a week or two. You will then move to another part of the hospital.
Nutrition and reducing the risk of blood clots
The care team will help you get started as quickly as possible. Exercise is important for your recovery because it helps reduce the risk of blood clots and respiratory infections. You start by getting into a sitting position and then taking short walks.
You may also have a tube in your stomach for liquid nutrition. Once the doctors are sure that your intestines can absorb nutrients and vitamins properly, you will slowly start eating by mouth again.
A dietitian will work closely with you so that you know what to eat and what not to eat. You slowly build up to a normal diet.
Duration of hospital stay
Your hospital stay may last 4 to 6 weeks. You should still closely monitor:
- sodium, potassium and iron levels in your blood
- vitamin and mineral content
- signs of infection
- kidney function
Some of these tests should be done once a week initially and then every few months.
While you are recovering, your doctor may recommend that you avoid crowds to reduce the chance of an infection.
You may not feel fully recovered for several months to a year. And you will need to continue taking immunosuppressants for the rest of your life to prevent organ failure. Your dose may need to be adjusted from time to time.
Surgeries involving a stomach transplant are complex and carry the risk of certain complications. Some of these are:
- infection
- Internal bleeding
- postoperative bleeding
- vascular leak or obstruction
- damage to surrounding organs
- thrombosis
- bile leaks or obstruction
- intestinal leaks
- organ rejection or organ failure
You may also be at increased risk for:
- certain types of cancer
- angst
- depression
Stomach transplants are not usually done alone, so it is difficult to give a prognosis based on this alone.
The first multivisceral transplant took place in 1983. The patient died immediately after the operation. Since then, surgical techniques and immunosuppressants have improved dramatically. However, it is still not a common surgery and long-term survival statistics are lacking.
In a
| Duration | Survival rate |
| 1 year | 70 percent |
| 5 years | 50 percent |
| 10 years | 40 percent |
Individual results vary greatly depending on factors such as:
- age, general health, underlying disease
- side effects and complications
- how well you can adhere to your medication and follow-up plan
Multivisceral transplantation is intended as a life-saving measure. Your doctor will review your health history and other factors to give you an idea of what to expect for your recovery.
Organ transplant surgery saves lives, but requires a lifelong commitment to monitoring and anti-rejection medications.
You can live without a stomach, so a stomach transplant is usually not an option unless other abdominal organs also fail.
In a multivisceral transplant, the stomach, intestines, pancreas, liver and possibly the kidneys are replaced. It is a complicated procedure with a long recovery period. But when other options fail, multivisceral transplantation can be a lifesaver.
