'Breakthrough Procedure'

Israeli Doctors Perform Country's First Intestine Transplant

The 39-year-old female patient is now recovering in intensive care after 'breakthrough' procedure for Israeli medicine.

Israel's first adult intestine transplant was performed on a 39-year-old woman at Beilinson Hospital, in Petah Tikva, over the weekend. The patient is recovering in the hospital's intensive care ward and her condition is stable.

The intestine transplant procedure is relatively rare and performed in only a few transplant centers world-wide.

The woman's small intestine was removed two years ago, due to a disease that caused benign tumors in her stomach and malignant tumors in her digestive system. She has been unable to eat since that operation and has been fed intravenously (called total parenteral nutrition, or TPN.) She was hospitalized frequently prior to the transplant due to her deteriorating condition.

The surgery, which lasted 10 hours, was conducted by a large team, including transplant surgeons, intensive care staff, gastroenterologists, anesthetists, operating theater nurses, Institute of Nutrition staff and blood bank staff. The transplant surgeons included Eviatar Nesher, a senior surgeon at the Department of Organ Transplantation, and professor Eytan Mor, the department’s director.

“The transplant was technically difficult due to the patient's deteriorating condition,” Nesher said after the transplant. “After surgery, the intestine seemed to be functioning properly and there was a good blood supply. The woman was moved to the intensive care in good condition.”

In 2008, an Israeli team performed an intestine transplant on a teenager. The surgery is complex, requiring specific surgical expertise and a huge supporting staff. Patients are kept in intensive care for two to three weeks after surgery and frequently checked for organ rejection. Patients begin to eat gradually, until the body is able to digest solid foods.

The survival rate of intestinal transplant patients is low compared to other transplants procedures, reaching 85 percent after one year and 60 percent after five years. The procedure is only performed when it is the only means of saving the patient’s life.

“In contrast to kidney, liver and pancreas transplants, intestine transplants are more complex and the danger of rejection or contamination continues for weeks after the process,” professor Mor said. “There are some 80 intestine transplants performed worldwide every year, and only a few transplant centers attempt the process. This is a breakthrough for Israeli medicine, putting us on the same level as leading transplant centers in the world. We are facing a long, challenging period until the intestine is fully accepted.”

Kobi Kalmanowitz