Recovery and What to Expect
The actual length of the transplant surgery can vary based on the type of transplant your child is receiving and the extent of abdominal pathology that your child has. The surgery can range from 8-16 hours. Throughout the transplant, the transplant team will give you updates on how your child is doing.
After the surgery, your child will go to the Pediatric Intensive Care Unit (PICU).
Your child will remain intubated (tube in his or her throat to help them breath) until it is safe to remove and they are able to breath on their own.
Your child will also have drains coming from his or her abdomen which help to drain any excess fluid that may accumulate from the transplant surgery.
These will remain in your child until the transplant team feels they are safe to remove, generally 2-3 weeks post-transplant.
You should also be aware that your child will have a nasogastric tube (NG) to help decompress and drain the stomach, a urinary catheter to drain urine, as well as many intravenous (IV) lines to help provide fluids and antibiotics to your child in the recovery phase.
As your child recovers and moves through the post-transplant phase, more of these lines and tubes will be removed and your child will start to feel more ‘normal’ again.
The hospital stay can be very upsetting for children.
Their daily routine and sleep patterns change.
They will also face strange and sometimes painful tests and meet many new people.
It is normal for them to be irritable and bad-tempered after this experience, especially if their stay in the hospital has been a long one.
Try to keep to familiar routine as much as possible during your child’s recovery. Bedtime routines are especially important for good sleep. Be sure to bring your child’s favorite blanket or toy that they use to fall asleep.
An ileostomy will be present after surgery:
This is a surgically created opening in the last segment of bowel (the ileum) through which waste passes.
The ileostomy is essential for monitoring the health of the transplanted bowel and will regularly be biopsied to check for rejection.
Biopsies will occur 1-2 times per week initially after transplant.
During the procedure, an endoscope is inserted into the stoma and advanced 4-8 inches.
The physician visually can observe the transplanted bowel.
A small pen point biopsy, piece of tissue, is taken from the transplanted bowel and analyzed under a microscope to determine if changes indicating rejection are present.
The first biopsy takes place 5-10 days after the transplant surgery.
Biopsies will be repeated a few times a week while your child is in the hospital after transplant, and then frequency will decrease as times goes on.