CPT® Code 44132

1. Indications

The open donor enterectomy procedure is indicated for the following conditions:

• Irreversible Intestinal Failure Patients who are unable to absorb nutrients through the gastrointestinal tract due to severe intestinal dysfunction.
• Life-Threatening Complications Individuals experiencing critical health issues as a result of long-term total parenteral nutrition, which may include infections, liver disease, or other serious complications.

2. Procedure

The procedure for an open donor enterectomy involves several critical steps to ensure the successful harvesting of the intestine from the donor.

• Step 1: Incision and Exposure The abdomen of the cadaver donor is incised to allow access to the abdominal cavity. This incision is made carefully to expose the organs that are to be harvested, including the intestine.
• Step 2: Dissection of Donor Organs Once the abdomen is opened, the donor organs are meticulously dissected from the surrounding tissue. This step is crucial to avoid damaging the organs during the harvesting process.
• Step 3: Separation of Intestine The intestine is then separated from the pancreas by carefully dissecting the superior mesenteric artery and vein. This step ensures that the blood supply to the intestine is preserved as much as possible during the harvesting process.
• Step 4: Harvesting the Intestine After the intestine is adequately separated, it is removed from the abdominal cavity. The harvested intestine is then perfused with a cold preservation solution to maintain its viability for transplantation.
• Step 5: Cold Preservation The intestine is placed on ice after perfusion with the preservation solution. This step is essential to keep the intestine in optimal condition until it can be transplanted into the recipient.

3. Post-Procedure

After the open donor enterectomy, the harvested intestine is prepared for transplantation. The preservation of the intestine is critical, and it must be transported to the recipient's surgical suite promptly. The surgical team must ensure that the intestine remains at the appropriate temperature and is handled carefully to prevent any damage. The recipient will then undergo a separate surgical procedure to receive the transplanted intestine, which involves re-anastomosing the intestine to restore continuity in the gastrointestinal tract. Post-operative care for both the donor and recipient will be necessary to monitor for any complications and to support recovery.