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Transplantation Large Intestine to Syngeneic with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | D Gastrointestinal System |
| Operation | Y Transplantation |
| Body Part | E Large Intestine |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | 1 Syngeneic |
Operation Definition
Putting in or on all or a portion of a living body part taken from another individual or animal to physically take the place and/or function of all or a portion of a similar body part
Procedure Overview
Transplantation refers to placing all or part of a gastrointestinal organ taken from another person, or in rare cases an animal source, into a patient to physically take over the function of their own diseased or absent organ. In the GI system this applies mainly to intestinal transplantation, performed for patients with intestinal failure who can no longer be sustained on intravenous nutrition alone, often due to short bowel syndrome, motility disorders, or complications of long-term parenteral feeding.
The donor intestine is surgically connected to the recipient's remaining digestive tract and blood vessels, and the patient begins lifelong immunosuppressive therapy to prevent rejection of the foreign tissue. Intestinal transplant may be performed alone or combined with liver transplantation when both organs have failed together.
This is a major, resource-intensive operation reserved for patients who have exhausted other treatment options, and outcomes depend heavily on careful donor matching, surgical technique, and post-transplant monitoring for rejection and infection.
Anatomy & Axis Detail
Large Intestine
Transplantation of the large intestine is rare as an isolated procedure and is typically undertaken only as part of a multivisceral transplant that includes the small intestine and other abdominal organs, since colon allografts carry a particularly high bacterial load and immunologic risk that make standalone transplantation uncommon. When included, the donor colon helps restore fluid absorption and bowel continuity for patients undergoing extensive visceral replacement. Because of its high risk of rejection and infection relative to other transplanted organs, the colon is sometimes deliberately excluded from a multivisceral graft even when other organs are transplanted, so documentation should confirm that colonic tissue specifically was part of the transplanted allograft rather than assuming it based on the broader procedure.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Qualifier: Syngeneic
This qualifier denotes a syngeneic tissue substitute, sourced from a donor who is genetically identical to the recipient, such as an identical twin. It is a narrower category than the allogeneic qualifier, which covers any same-species donor regardless of genetic match, and is distinguished from zooplastic tissue, which comes from another species.
Coding & Documentation
Coding Transplantation requires documentation confirming the tissue originated from a donor - another individual or, rarely, an animal - rather than from the patient's own body, which would instead be Transfer or an autograft procedure elsewhere in the classification. Operative and pathology notes should identify the donor source and confirm the transplanted organ was placed to assume the recipient's physiologic function. A frequent error is applying Transplantation to autologous tissue relocation, or failing to code a combined multivisceral transplant with all applicable body part values when liver and intestine are transplanted together. Coders should also review whether the procedure was a full organ or a segmental transplant, since this affects body part selection.