A transplantation of all abdominal organs, also known as a multivisceral transplant, is performed when multiple abdominal organs fail and have to be replaced by healthy organs. This rare and invasive procedure is also a treatment option in patients with extensive thrombosis of the abdominal vessels or for certain tumours. This procedure is for some patients the only live-saving option.
This type of multivisceral transplant in a toddler is incidentally also a first within Eurotransplant, which included eight countries: Austria, Belgium, Croatia, Germany, Hungary, Luxemburg, the Netherlands and Slovenia.
Complex procedure
A transplant where all abdominal organs are being replaced, requires intense collaboration between specialists of various disciplines and departments: transplant surgeons, specialised anaesthesiologists and intensivists, interventional radiologists, perfusionists, gastroenterology and hepatology specialists, peadiatricians and transplant coordinators and nurses.
When a suitable donor presents itself, the first priority is to get this multidisciplinary team up and running at short notice. Then two surgical teams simultaneously operate on the donor, which is often found abroad, and the receiver in order to reduce the retention time. Especially intestines need to be moved very quickly from one body to the other. This type of invasive procedure also holds big risks for the patients cardiovascular and metabolic system, especially when removing the sick organs and restarting the blood circulation of the new organs after implantation. After the transplant the patient will be monitored for the rest of his life.
We mobilise various teams and specialists at very short notice and sometimes in the middle of the night
Prof. dr. Jacques Pirenne, head of the abdominal transplant surgery department at UZ Leuven: “The organisation of a multivisceral transplant is a challenge: We mobilise various teams and specialists at very short notice and sometimes in the middle of the night. We are therefore very pleased to announce that the young patient is doing well and is able to eat normally again.”
Multivisceral transplants at UZ Leuven
UZ Leuven already performed nine similar multivisceral transplants, eleven combined liver-pancreas-intestinal transplants (without the stomach) and nine isolated intestinal transplants in adults and children. Instestines are particularly susceptible to rejection, but the simultaneous transplant of the liver and the small intestine (as was the case for this young patient) and the standard application of a specially designed protocol improve the outcome. The 5 year survival rate of patient is 80%, similar to other organ transplants.
© UZ Leuven
UZ Leuven had by now become an international reference centre for the treatment of patients with intestinal failure and intestinal transplants. Six years ago, the Leuven Intestinal Failure and Transplantation Center (LIFT) was set up, a unique multidisciplinary evaluation and treatment centre for patients with intestinal failure. Under the supervision of prof. dr. Tim Vanuytsel (gastro-enterologist), prof. dr. Laurens Ceulemans and prof. dr. Jacques Pirenne (transplant surgeons) the centre stimulates Leuvense gastro-enterologists, abdominal surgeons and transplant surgeons to research ground-breaking treatment methods together.