The Silvestre Adventist Hospital, part of the Adventist Health Brazil network, performed the first isolated bowel transplant in the state of Rio de Janeiro, Brazil, on September 5. The patient, Viviane, underwent the surgery performed in partnership with the Unified Health System (SUS).
The operation lasted approximately six hours. Viviane received a small and large intestine transplant, without the simultaneous transplantation of organs such as the liver, pancreas, or stomach. Viviane presented with short bowel syndrome, intestinal failure, and severe malnutrition as consequences of Crohn's disease, conditions that compromised the absorption of nutrients necessary for the body.
For Viviane, the transplant represents the hope of regaining her health and resuming plans interrupted by the illness.
"I hope it brings back all the dreams I couldn't fulfill. That it gives me strength, health, and the means to remain the person I am," she said.
Highly complex procedure
Although rarely performed in Brazil, intestinal transplantation is warranted in specific situations such as serious complications associated with prolonged use of parenteral nutrition, which provides nutrients directly into the bloodstream through a catheter. According to Ranieri Leitão, medical director of Silvestre Hospital, Viviane had been exclusively dependent on this support for several years.
Eduardo Fernandes, chief surgeon and coordinator of the liver and multivisceral transplant unit, explained that the team already had experience in multivisceral transplants, which involve transplanting several organs simultaneously. He explains that "some of them participated in the first multivisceral transplant in the state, with the combined transplantation of the small intestine, liver, pancreas, and stomach."
According to surgeon Felipe Pedreira Tavares de Mello, the operation went without complications. He explains that previous surgeries can leave adhesions, internal scars that make a new intervention more difficult.
“To our surprise, we found a slightly more favorable scenario than we had imagined. The surgery went extremely well, without any complications, and we are very hopeful about the success of the procedure as a whole,” he noted.
Experience in transplants
Since 2010, the Silvestre Adventist Hospital has performed 1,688 kidney and liver transplants. Its history also includes the world's first pancreas transplant using the isolated segmental technique, which utilizes part of the donor's organ.
Currently, seven of the 12 surgeons on the liver transplant team are women. Most of these professionals completed their residency at the hospital and built their careers within the institution. The team also sought training in the United States for intestinal transplantation.
"It's been many years of dedication, study, and experience. For what happened today to happen, many years of accumulating experience were required," Fernandes stated.
Speaking about the care she received, Viviane emphasized her admiration for medicine and the people who dedicate themselves to patients.
“I think medicine is beautiful. These discoveries, these ways they find to help others. The empathy, the love for others. Helping human beings. I find that very beautiful.”
Green September
The procedure took place during Green September, a month dedicated to raising awareness about the importance of organ donation. According to Cristian Denis da Silva, general director of the Silvestre Adventist Hospital, the event reflects the team's preparedness and the institution's history.
“This moment crowns our celebration of 16 years of pioneering work in liver and kidney transplants, a journey built on science, experience, and above all, a commitment to life,” Silva stated. “And in the midst of Green September, we praise God for this achievement, another historic moment as we perform the first intestinal transplant, opening a new chapter in this journey.”
The original article was published on the Silvestre Adventist Hospital news site.
