Our trip to Georgetown was very busy and informative.  We knew that all transplants are difficult and have a certain level of risk, but we learned that the small bowel is the most difficult organ to transplant because it has the greatest risk.  The small bowel has a lot more immune cells than most other organs, and so small bowel transplants require much larger amounts of immunosuppressant medications in order for the body not to reject the new organ.  This makes the transplant recipient much more susceptible to sicknesses and is why small bowel transplants are generally a last resort.

We had known that a transplant wouldn’t be easy, but this was sobering news.  Then, the doctor told us about another procedure which has proven to have some level of success for patients meeting certain physical conditions.  This procedure involves reconnecting the small intestine to the colon and giving daily hormone injections to the patient. Amanda has about 5 percent of her small intestine remaining and over half of her colon. If the procedure is successful, over time the hormones will thicken the remaining small intestine and colon walls and the colon will begin to absorb nutrients and function like the small intestines.  The goal is for the patient to eventually be able to absorb enough nutrients and calories to sustain themselves and no longer need TPN. Amanda’s petite size works in her favor with this procedure because her caloric needs are lower.

In Amanda’s bedroom is a picture of a bridge leading to a pathway.  The caption under the picture reads “Just because it was not what you were expecting doesn’t mean it wasn’t everything you were waiting for.”  While we don’t know if this procedure will work for Amanda, it is the recommendation of the Georgetown Medstar transplant team that we try this less risky procedure before going through with a transplant.  At the beginning of this journey, we prayed for guidance to choose the best medical team for Amanda and we feel we have been led to the Georgetown Medstar team.  We trust their expertise and Amanda will be having the surgery they recommend on July 18^th at the Georgetown University Hospital.