Stomach transplant surgery isn’t done often and it’s typically not a stand-alone surgery. A stomach transplant is usually performed as part of multiorgan transplant surgery.
Read on to learn more about stomach 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. Stomach transplantation is not normally done by itself but in combination with other abdominal organs.
A multivisceral transplant is a procedure that involves replacing the:
- stomach
- pancreas
- liver
- small and/or large intestine
- and possibly the kidneys
In a modified multivisceral transplant, you keep your own liver.
Stomach transplants are typically done when other gastrointestinal organs are also diseased and there’s no other way to treat them. Some reasons your doctor might suggest multivisceral transplant are:
- cancer
- desmoid tumor with intra-abdominal infiltration
- endocrine tumors
- gastroschisis
- vascular abdominal trauma
- various congenital abnormalities
With any organ transplant, you need to take anti-rejection medications for the rest of your life. There are also a fair number of potential complications.
There are many types of stomach problems, but a stomach transplant by itself isn’t medically necessary. That’s because, as hard as it is to imagine, you can live without a stomach.
Some conditions, such as stomach cancer, may call for partial or complete removal of the stomach. If the cancer hasn’t spread outside the stomach, there’s no need to remove other abdominal organs.
When the entire stomach is removed, it’s called a total gastrectomy. In this procedure, the surgeons connect the esophagus to the small intestine. In some cases, they’ll also create a small pouch to accommodate a little more food.
Either way, you’ll still have a functioning digestive system. You’ll gradually be able to introduce regular foods and within a few months should have a relatively normal diet. But big meals are a thing of the past. You’ll need to eat much smaller meals throughout the day.
The lead-up to organ transplantation is generally a long one. Much depends on the availability of healthy compatible organs and coordination of surgical teams on both ends.
The surgery is complicated. Members of the surgical team may include:
- surgical nurses
- anesthesiologist
- gastroenterologist
- transplant surgeon
- transplant hepatologist (liver specialist)
- radiologist
Procedural steps
The procedure takes approximately 8 to 12 hours and will include the following steps:
- A general anesthesia is administered.
- A surgeon makes a long incision across the abdomen.
- The abdominal organs are examined for signs of infection or anything else that could interfere with successful transplantation.
- The organs being replaced are removed.
- The surgical team implants the donor organs. Because it involves multiple organs, the surgical team will have to reestablish many vital connections such as the flow of GI contents, veins, and arteries.
- The surgeons make sure all bleeding is controlled.
- The incision is closed.
Depending on the specifics of your surgery, the surgeon may create a stoma. This allows solid waste to leave through an opening in your abdomen. The waste collects in a bag outside the body. This may be temporary.
Your recovery will begin in the intensive care unit (ICU). You’ll be receiving intravenous (IV) fluids, nutrition, and medicines. Monitoring equipment will keep track of vital signs such as heart rate, breathing, and blood pressure.
At the incision site, you’ll have several drains to help rid your body of excess liquids from the surgery. They’re only temporary.
Medications you may take
Among the medications you might receive at this time are:
- Immunosuppressants. These anti-rejection medications ensure that your immune system doesn’t reject your new organs.
- Anti-infection medications. These medications help your weakened immune system fight infection.
- Pain relievers or other medications. Additional medications may be given to treat side effects of surgery or other medical conditions.
Depending on how well your recovery goes, you’ll stay in the ICU for a week or two. Then you’ll move to another area of the hospital.
Nutrition and reducing the risk of blood clots
As soon as possible, the nursing team will help you get moving. Moving is important for your recovery because it helps reduce the risk of blood clots and chest infection. You’ll start by getting into a sitting position, then taking brief walks.
You may also have a feeding tube in your stomach for liquid nutrition. Once doctors are certain that your intestines can properly absorb nutrients and vitamins, you’ll slowly return to eating by mouth.
A dietician will work closely with you, so you know what to eat and what to avoid. You’ll slowly build up to a normal diet.
Length of hospital stay
Your hospital stay could last 4 to 6 weeks. You’ll still need close monitoring of:
- sodium, potassium, and iron levels in your blood
- vitamin and mineral levels
- signs of infection
- kidney function
Some of these tests may have to be performed once a week at first, then every few months.
While you’re recovering, your doctor may recommend that you avoid crowds to lower your chances of contracting an infection.
You may not feel fully recovered for several months to a year. And for the rest of your life, you must continue taking immunosuppressant drugs to avoid organ failure. Your dose may have 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 hemorrhage
- vascular leaks or obstruction
- damage to surrounding organs
- thrombosis
- bile leaks or obstruction
- intestinal leaks
- organ rejection or organ failure
You might also be at increased risk of:
- certain types of cancer
- anxiety
- depression
Stomach transplants aren’t usually performed on their own, so it’s difficult to provide a prognosis based on this alone.
The first multivisceral transplant took place in 1983. The patient died right after surgery. Since then, surgical techniques and immunosuppressive medications have improved dramatically. It’s still not a common surgery, though, and long-term survival statistics are lacking.
In a
| Length of time | Survival rate |
| 1 year | 70 percent |
| 5 years | 50 percent |
| 10 years | 40 percent |
Individual outcomes vary a lot based on factors such as:
- age, overall health, underlying disease
- side effects and complications
- how well you can adhere to your medication and follow-up schedule
Multivisceral transplantation is intended as a lifesaving measure. Your doctor will review your health history and other factors to give you some idea of what to expect for your recovery.
Organ transplant surgery saves lives, but it requires lifelong commitment to monitoring and anti-rejection medications.
You can live without a stomach, so stomach transplant surgery isn’t usually a choice unless other abdominal organs are also failing.
Multivisceral transplantation involves replacing the stomach, intestines, pancreas, liver, and possibly the kidneys. It’s a complicated procedure with a long recovery period. But when other options fail, multivisceral transplantation can be a lifesaver.
