Intestine transplantation surgery is possible today because of pioneering work by Seattle Children’s doctors. What started as an experimental procedure is now an important part of treating children with permanent intestinal failure. Our doctors also work to avoid the need for transplants by improving intestinal care.

Reducing the Need for Transplant

Some of our research in the Intestinal Care Program aims to find out more about conditions that lead to intestinal failure. That’s one way we try to limit the need for transplantation.

We’re also exploring how to improve bowel function to lessen the need for total parenteral nutrition (TPN). TPN is a complete form of nutrition given through a vein. It can be a lifesaver for children whose intestines are not working right. But if used long-term, it can result in liver failure.

New approaches are being studied by Dr. Simon Horslen, Seattle Children’s medical director of liver and intestine transplantation, and Dr. Patrick Javid. Javid is an attending surgeon in Seattle Children’s Division of Pediatric General and Thoracic Surgery.

Seattle Children’s is active in international groups focused on intestinal failure in children. Sharing information helps us understand the condition better, improve treatments and increase patient survival. These groups include the Pediatric Intestinal Failure Consortium, Intestinal Transplantation Society and International Intestinal Transplant Registry.

Multiple Organ Transplants

Intestinal failure can lead to failure of other organs – especially other parts of the digestive system or the liver. Children whose intestines are failing may need multiple-organ replacements. These are also called multiple-viscera transplants. Our transplant team, led by Dr. Jorge Reyes, director of Transplant Services, has performed close to 1,000 transplants in children needing new intestines or both liver and intestines.

Our research into new intestinal care options that limit the use of TPN aims to keep children’s other organs healthy. We hope to reduce the need for multiple organ transplants.

Read about research related to livers and the digestive system at Seattle Children’s. Learn about participating in research.

Balancing Risks of Rejection and Infection

We are finding better ways to prevent rejection of the new intestine while keeping a child’s immune system strong enough to fight infection. Thanks to past research, we now know that a child’s body needs a certain amount of reaction against a new organ to adjust to it.

Dr. Reyes also leads efforts to improve antirejection drug mixtures for children after surgery. Steroids are used less because of research by Reyes and others.