Cleveland Clinic
Specialty Services Symposium: Medical, Surgical and Quality
June 3, 2008 InterContinental Hotel & Bank of America Conference Center | Cleveland, Ohio

Cleveland Clinic Intestinal Rehabilitation and Transplant Program Receives CMS Certification


Pre-Transplant Diagnoses In The Adult Population

Referring Patients For Intestinal Transplant Medicare Guidelines

Failure of HPN (Home Parenteral Nutrition)

  • Impending (total bilirubin 3–6 mg/dL, progressive thrombocytopenia, and progressive splenomegaly) or overt liver failure (portal hypertension, hepatosplenomegaly, hepatic fibrosis, or cirrhosis) because of parenteral nutrition-liver injury
  • Central venous catheter (CVC)–related thrombosis of 2 central veins
  • Frequent central line sepsis: 2 episodes/year of systemic sepsis secondary to line infections requiring hospitalization; a single episode of line-related fungemia; septic shock or acute respiratory distress syndrome
  • Frequent episodes of severe dehydration despite intravenous fluid in addition to HPN

High risk of death attributable to the underlying disease

  • Desmoid tumors associated with familial adenomatous polyposis
  • Congenital mucosal disorders (eg, microvillus atrophy, intestinal epithelial dysplasia)
  • Ultrashort bowel syndrome (gastrostomy, duodenostomy, residual small bowel 10 cm in infants and 20 cm in adults)

Intestinal failure with high morbidity or low acceptance of HPN

  • Intestinal failure with high morbidity (frequent hospitalization, narcotic dependency) or inability to function (eg, pseudo-obstruction, high output stoma)
  • Patient’s unwillingness to accept long-term HPN (eg, young patients)

For questions or to refer a patient to The Cleveland Clinic Intestinal Rehabilitation and Transplant Program, please call 216-312-0308

The Cleveland Clinic Intestinal Rehabilitation and Transplant Program (IRTP), within the Digestive Disease Institute, recently received Centers for Medicare and Medicaid Services (CMS) certification.  This accreditation, which is only granted to transplant programs that meet strict volume and quality criteria, represented a prestigious achievement and it is expected to facilitate patients' access to this much-needed program.


Cleveland Clinic Intestinal Rehabilitation and Transplant Team

The IRTP program, led by Cristiano Quintini, MD, performed its first intestinal transplant in July 2008. Since then, 18 transplants have been performed with an overall patient survival rate close to 70 percent.  In 2010, 10 intestinal transplants were performed including a combined kidney and intestinal transplant.

There are currently 46 intestinal transplant programs active in the country and only 15 are CMS certified. Cleveland Clinic program is only one of eight programs certified and specialized in the care
of adult patients.

The IRTP offers advanced medical and surgical treatment to patients with intestinal failure.  The team is staffed by dedicated surgeons, gastroenterologists, nurses, advanced practitioners, dieticians and social workers who interact closely with other specialties within the Digestive Disease Institute.

With the newly certified intestinal transplant program, Cleveland Clinic transplant center becomes one of the largest and certainly the most comprehensive transplant centers in the country able to offer all solid organ transplants along with composite tissue transplant.

If you have any questions or would like to refer a patient, contact the Intestinal Rehabilitation and Transplant Program (IRTP) 24-hour referral hotline at 216.312.0308, e-mail [email protected], or visit the Interstinal Rehabilitation and Transplant Program website.



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