Getting the Go-Ahead
When an intestine from a deceased donor is available, an organ procurement organization contacts Seattle Children’s.
Both a transplant nurse coordinator and a transplant surgeon are on call 24 hours a day at Seattle Children’s. The transplant nurse coordinator and the transplant surgeon will discuss the history and condition of the donor organ to determine if it would be a good match for your child.
If the organ is a good match, the transplant nurse coordinator will contact you to see if your child is able to undergo the transplant surgery. The transplant nurse coordinator must make sure that your child does not have any new health problems that might require delaying transplant surgery, such as a cold or the flu.
United Network for Organ Sharing (UNOS) policy requires that the transplant center (the Seattle Children’s transplant team) decide if they are going to accept the organ within 1 HOUR.
Intestine Transplant Surgery
The time of your child’s transplant surgery is planned to match the intestine’s arrival at Seattle Children’s. The intestine cannot live long outside a body, so it must be removed from the donor, transported quickly to Seattle Children’s and then transplanted into your child all within a few hours.
When your child is asleep in the operating room, the transplant team will insert additional IV lines. These lines will include a line into an artery so that the team can monitor your child’s blood pressure and take blood samples as needed.
The team will also insert a thin tube (central venous catheter) into a large vein to deliver larger amounts of medicines and fluids than we can using a regular IV.
The surgeon will take out the diseased parts of your child’s intestine. Next, the surgeon will attach the donor intestine and any other needed donor organs. For the intestine, your child’s blood vessels will be connected to those of the donor organ and then the new intestine will be connected at both ends.
During this part of the procedure, the surgeon will also create a small temporary opening (stoma) in the lower part of your child’s small intestine. This procedure is called an ileostomy, and it gives your child’s transplant team easy access to the new intestine through the stoma. It will help the team monitor the transplant and check for signs of rejection.
The surgeon will also place a tube at the upper end of the donor intestine near your child’s stomach. This tube (jejunal tube) reduces pressure in your child’s gut so that your child can process food better and get their nutrition from food rather than from intravenous nutrition.
The operating room staff will let you know how your child is doing during the surgery. They will contact you through the pager you got from the NICU.