**5. Recipient assessment**

The assessment of a potential intestinal transplant recipient is robust and rigorous and needs to be done by a multidisciplinary team. This involves transplant surgery, gastroenterology, nutritional services, anesthesia, psychiatry and social work. However, due to the frequently pre-existing multiple comorbidities, consultation with other specialties may be required. Every assessment is 'tailor-made'.

Laboratory studies always include: full blood count (FBC), electrolytes and renal function, coagulation profile, ABO blood group, human leukocyte antigen (HLA) typing, panelreactive antibody status, HIV and hepatitis B and C virus screening, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) screening.

Liver biopsy is indicated, if liver disease is suspected. The native intestine should be assessed both by imaging and endoscopy.

Vascular access is of utmost importance and is assessed by magnetic resonance or computed tomography venogram. Securing upper-body vascular access is mandatory in cases where IVC occlusion is anticipated. Many patients will have central venous stenosis or obstruction and will mandate interventional radiology and/or vascular reconstruction before listing.

Manometry of the esophagus, stomach and rectum should be considered in patients with dysmotility disorders.

While on the waiting list, patients should be frequently reassessed, with specific attention given to any change in medical status, deterioration in liver function or vascular access.
