A stomach transplant surgery is usually not a stand-alone surgery and is performed as a part of multiorgan transplant surgery.

As the name suggests, the deceased’s stomach is replaced with a healthy stomach from a donor. It is usually a part of a multivisceral transplant, that includes the replacement/ transplant of the stomach, pancreas, liver, intestine, and kidneys. 

When is a stomach transplant done?

There can be a lot of reasons you might be suggested to go for a stomach transplant by your doctor. Some of these conditions can be stomach cancer, endocrine tumors, congenital abnormalities, gastroschisis, etc.

When the entire system is removed from the body, it is called a total gastrectomy. This involves connecting the esophagus to the small intestine. A partial gastrectomy, on the other hand, involves the removal of a part of the stomach, like lymph nodes and fatty tissues. 

However, not everyone is a good candidate for a stomach or multi-visceral transplant. People with the following health conditions are generally deemed not to be fit candidates for such a transplant.

  1. An infection
  2. Some types of cancer
  3. Advanced HIV
  4. Cerebral edema
  5. Multi-system organ failure

Risks and complications associated with a stomach transplant:

Stomach surgeries aren’t very simple, they involve a lot of minute complications, like:

  1. Internal bleeding
  2. Infections
  3. Postoperative hemorrhage
  4. Bile leaks
  5. Intestinal leaks
  6. Organ failure
  7. Damage to surrounding organs
  8. Increased risk of certain cancers
  9. Increased risk of anxiety and depression
stomach transplant surgery

Surgery for stomach cancer

If cancer in the stomach has not spread to other body parts, surgery can be a good option to cure cancer. In cases of stomach cancer, surgery is done mainly for two reasons: to remove cancer or palliative surgery.

  1. Surgery to remove cancer: The type of surgery to be performed in cases of stomach cancer depends on the type of infection and its spread in the body. Some surgeons also try to leave as much stomach as they can in the body so that patients can be allowed to eat more normally even after the surgery. The basic thing every surgeon tries to achieve via surgery is to achieve negative surgical margins, i.e. no cancer cells at the edges of the parts of the stomach that have been removed. 
  2. Palliative surgery for unresectable cancer: In cases where the stomach cancer cannot be completely removed, surgery can be performed to control cancer or relieve the symptoms. It can be done by a gastric bypass, subtotal gastrectomy, or endoscopy. 

Effects of surgery

With improved skill sets and techniques over the years, stomach surgeries are mostly successful these days.

After surgery takes place, after a total gastrectomy, eating or drinking anything is generally prohibited for some days. This gives time to the digestive tract to heal from the operation properly and prevent any kind of leakages.

The patient can also experience some side effects after stomach surgery, like nausea, abdominal pain, heartburn, etc. 

A gastrectomy also requires some changes in diet post-surgery, like you would be required to eat smaller meals frequently throughout the day, and avoid any big meals. Sometimes, a J tube or jejunostomy tube is placed into the intestine, so that liquid nutrition can be put directly into the intestine through this tube. 

Moreover, some patients can also go through some kind of vitamin deficiency, since the stomach helps the body to absorb certain vitamins. Vitamin supplements can be prescribed by your doctor for this purpose. 

Image from indiatimes.com

Tips for post gastrectomy:

The removal of the stomach from your body will mean that you wouldn’t be able to eat the same quantity of the food as you did before surgery, so you will have to take the calories in smaller amounts of high-calorie foods. Some eating tips after you’ve gone through a gastrectomy are:

surgery for the stomach
  • Eat small meals within every 2 to 3 hours at least.
  • Eat a variety of foods, including fruits, vegetables, whole grains, dairy foods, etc.
  • Drinking beverages like milk, eggnog, or unsweetened juice can be better options than tea, coffee, or water. Such nutrient-dense liquids can help you supply more calories and are also easier to consume than most solid foods. 
  • Taking small bites and thoroughly chewing your food is one suggestion that can be quite important since your stomach is not there anymore to do the grinding and breakdown of food. 

Risk of blood clots: 

Stomach surgery involves an inherent risk of developing blood clots. This is one reason patients are made to move soon after surgery since it helps with blood clots. 

If you have an intestinal tube, it will take some time for you to return to your normal eating by mouth routine, once your doctor is certain that your intestine is in a good enough position to absorb nutrients and vitamins. 

Slowly and gradually, you will be able to resume a normal diet.

Medications that you might receive at this time include:

  1. Immunosuppressants: these make sure that your immune system doesn’t reject your new organs and becomes friendly with them
  2. Pain relievers: to treat any kind of side effects in the form of pain
  3. Anti-infection medications: these help weaken the immune system and fight infections in the body.

Outcome

The outcomes of a stomach transplant can be dependent on a lot of factors like age, any underlying disease or medical condition, complications, medications, etc. 

When the first multi-visceral transplant took place back in 1983, the patient died right after the surgery. Since then, the field of medicine, surgical techniques, and immunosuppressive medications have advanced drastically. 

This is all about surgery for the stomach. Since life without a stomach is possible, stomach surgery can even be avoided unless other organs are also on the verge of failing. This means multi-visceral transplantation which is generally a complicated procedure with a long recovery period. However, it can be a lifesaver when most of the other options for transplant and surgery fail.