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Total parenteral nutrition and cholestasis
I S Sandhu1, C Jarvis, G T Everson
1Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Denver, Colorado, USA.
Clinics in Liver Disease
|April 9, 2001
Summary
Total parenteral nutrition (TPN) can cause liver problems. This review outlines how to assess abnormal liver tests in TPN patients and explores treatment options, including intestinal transplantation.
Area of Science:
- Hepatology
- Gastroenterology
- Clinical Nutrition
Background:
- Hepatobiliary dysfunction is a significant complication associated with total parenteral nutrition (TPN).
- The exact cause remains unclear, with potential links to TPN solution composition or the patient's underlying disease.
- Abnormal liver tests are common in patients requiring TPN.
Purpose of the Study:
- To provide a framework for evaluating abnormal liver tests in patients receiving TPN.
- To discuss current treatment strategies for TPN-induced hepatobiliary dysfunction.
- To review the role and status of intestinal transplantation in managing these complications.
Main Methods:
- Literature review of studies on TPN-associated liver injury.
- Development of diagnostic algorithms for abnormal liver function tests in TPN patients.
- Synthesis of information on therapeutic interventions and intestinal transplantation outcomes.
Main Results:
- Algorithms are presented to guide the diagnostic process for abnormal liver tests in TPN patients.
- Various treatment options are discussed, addressing different aspects of hepatobiliary dysfunction.
- The current landscape and potential of intestinal transplantation are examined.
Conclusions:
- Systematic evaluation is crucial for managing liver abnormalities in TPN patients.
- A multi-faceted approach involving diagnostic algorithms and tailored treatments is necessary.
- Intestinal transplantation represents a potential, albeit complex, therapeutic avenue.