Multivisceral Transplant
Transplant
Starting from
$250,000
Up to $450,000 depending on centre
Typical duration
60–150 days
Including pre-operative work-up
Content reviewed for medical accuracy by: Dr. Rodina Ainasoa · Medical Content Writer & Health Communications
Overview
Simultaneous en-bloc transplantation of multiple abdominal organs — typically stomach, small intestine, pancreas, and liver, with or without the colon — for patients with irreversible intestinal failure combined with liver failure (often from long-term total parenteral nutrition) or diffuse mesenteric/portal venous thrombosis that makes isolated intestinal or liver transplant unfeasible. This is distinct from our Combined Organ Transplant program, which covers kidney-pancreas, heart-lung, and liver-kidney combinations only — multivisceral transplant is an intestinal-failure procedure performed at a small number of ultra-specialized centers worldwide.
Your case is matched to a centre on the basis of clinical outcome data, not marketing. We coordinate every step — from pre-operative work-up to post-treatment follow-up — with a dedicated care coordinator.
What's included
Multivisceral Transplant
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Full vs. Modified (Liver-Sparing) Multivisceral Transplant
Multivisceral transplant can be performed as a full en-bloc graft including the liver, or as a modified, liver-sparing graft that preserves the patient's own liver. Which approach is appropriate is determined by a multidisciplinary transplant surgery, hepatology, and gastroenterology team based on whether liver failure is present — never a self-assessment.
| Parameter | Full Multivisceral (with Liver) | Modified Multivisceral (Liver-Sparing) |
|---|---|---|
| Indication | Used when intestinal failure is combined with irreversible liver failure, most commonly from long-term parenteral-nutrition-associated liver disease, per NCBI/StatPearls. | Used when the native liver can be preserved — for example, diffuse mesenteric/portal venous thrombosis or extensive abdominal tumors without established liver failure, per NCBI/StatPearls and the Intestinal Transplant Registry. |
| Organs transplanted | Stomach, small intestine, pancreas, and liver as a single en-bloc graft, with or without the colon, per the Intestinal Transplant Registry. | Stomach, small intestine, and pancreas, with the patient's own liver left in place, per NCBI/StatPearls. |
| Immunological complexity | Including the liver in the graft is associated with a protective effect against chronic rejection of the intestinal component, per peer-reviewed transplant immunology studies. | Without the liver's immunomodulatory effect, the intestinal graft may carry a comparatively higher chronic-rejection consideration, which the transplant team factors into immunosuppression planning, per peer-reviewed studies. |
| Candidacy & suitability | Requires confirmed irreversible liver failure alongside intestinal failure; assessed by a multidisciplinary transplant board, per Mayo Clinic and NCBI/StatPearls. | Requires confirmed preserved liver function; suitability is assessed by the same multidisciplinary transplant board on a case-by-case basis. |
The Procedure: Step by Step
The description below outlines the general multivisceral transplant process. Your transplant surgical team will confirm the specific organ combination and steps for your case.
Multidisciplinary evaluation & organ-cluster listing
A transplant surgery, hepatology, gastroenterology, and nutrition team confirms the diagnosis of intestinal failure with liver failure or diffuse mesenteric/portal thrombosis, and lists the patient for a deceased-donor multivisceral organ cluster, per NCBI/StatPearls.
Recipient hepatectomy/enterectomy & vascular preparation
Under general anaesthesia, the surgical team removes the diseased native organs being replaced and prepares the major abdominal vessels for the incoming graft, a step that is markedly longer and more complex than a single-organ transplant, per the Intestinal Transplant Registry.
En-bloc graft implantation & vascular reconstruction
The donor organ cluster — stomach, small intestine, pancreas, and (for a full multivisceral graft) liver — is implanted as a single en-bloc unit, with the graft's major arteries and veins reconstructed to the recipient's circulation, per NCBI/StatPearls.
Bowel continuity, closure & stoma creation
Gastrointestinal continuity is restored and a temporary ileostomy is typically created to allow direct visual monitoring of the intestinal graft for rejection; the abdomen is then closed and the patient is transferred to intensive care, per the Intestinal Transplant Registry.
Recovery Timeline
The transplant surgery itself is markedly longer than single-organ transplants given the number of organs and vascular reconstructions involved, per NCBI/StatPearls.
Initial hospitalisation, including extended intensive care monitoring, typically runs several weeks, longer than for isolated liver or kidney transplant, per the Intestinal Transplant Registry.
Frequent endoscopic surveillance biopsies through the temporary ileostomy monitor for early signs of intestinal graft rejection, alongside close nutritional-status monitoring, per NCBI/StatPearls.
Full recovery and transition off parenteral nutrition, where achievable, typically takes many months; over 90% of long-term survivors regain full nutritional autonomy, per International Intestinal Transplant Registry data.
Source: NCBI/StatPearls "Intestinal and Multivisceral Transplantation"; International Intestinal Transplant Registry. Individual recovery and results vary and are guided by your transplant surgical team.
Known Risks & Limitations
- This is one of the most complex procedures in transplant surgery; five-year patient survival is in the range of roughly 50–60% depending on recipient age and organ combination, per International Intestinal Transplant Registry (IITR) data.
- Acute cellular rejection of the intestinal component remains the most significant immunological challenge, requiring intensive early surveillance via endoscopic biopsy through the temporary ileostomy, per NCBI/StatPearls.
- Post-transplant lymphoproliferative disorder and opportunistic infection risk are elevated given the intensity of immunosuppression required, particularly for the intestinal graft, per peer-reviewed transplant literature.
- As with any major abdominal transplant surgery, risks include bleeding, vascular thrombosis, anastomotic leak, and prolonged intensive-care recovery given the scale of the operation, per the Intestinal Transplant Registry.
- There is no robotic or minimally invasive alternative to this procedure — it is major open abdominal surgery requiring en-bloc removal and reconstruction of multiple organs, per NCBI/StatPearls.
Source: NCBI/StatPearls; International Intestinal Transplant Registry; UNOS; peer-reviewed transplant immunology literature. No procedure is without risk; your transplant team will review your individual case.
The CureSureMedico Care Pathway
Remote clinical review
Share your intestinal-failure and, if applicable, liver-failure history, imaging, and nutritional status. Our coordination team forwards your case to a multivisceral transplant surgical team for an initial candidacy assessment.
Center identification & multidisciplinary review
Given how few centers globally perform this procedure, our coordinators identify and confirm capacity with an appropriate high-volume program and arrange the multidisciplinary transplant-board evaluation your case requires.
Clinic matching & estimate
A consolidated cost estimate covering pre-transplant work-up, the multivisceral transplant surgery, and extended post-operative intensive care is issued before you travel.
Transplant surgery & extended recovery
Travel, final pre-operative work-up, the transplant surgery itself, and the extended intensive-care and inpatient recovery period are coordinated with your care team throughout, including endoscopic rejection-surveillance scheduling.
Continuity of care post-return
A discharge summary, immunosuppression regimen, and nutrition-transition plan are shared with your home transplant/hepatology team before you travel home, with remote coordination available for ongoing monitoring and any questions that arise.
Global cost comparison — Multivisceral Transplant
Average coordinated costs across our partner centres. Final pricing depends on clinical complexity and chosen hospital.
| Country | Avg. cost | vs. cheapest |
|---|---|---|
🇺🇸 US | $350,000 | +25% |
🇹🇷 Turkey Istanbul | $280,000 | —chevron_right |
Costs are indicative estimates and vary by procedure specifics, hospital, and clinical complexity. Request a personalised estimate for your specific case.
Frequently asked questions
Multivisceral transplant is reserved for patients whose intestinal failure is combined with liver failure (commonly from years of parenteral-nutrition-associated liver disease) or with diffuse thrombosis of the mesenteric and portal venous system, which makes isolated intestine or isolated liver transplant technically unfeasible or insufficient. Instead of replacing one organ, the surgical team replaces an en-bloc cluster — typically stomach, small intestine, pancreas, and liver, occasionally including the colon — restoring gut continuity and metabolic function in a single operation. A liver-sparing "modified multivisceral" variant is used when the native liver can be preserved, per NCBI/StatPearls and the Intestinal Transplant Registry.
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