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Liver dysfunction and parenteral nutritional therapies
1Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Clinics in Liver Disease
|November 25, 2004
Summary
Long-term total parenteral nutrition (TPN) frequently causes hepatobiliary dysfunction. This review explores causes, prevention, and treatment strategies for TPN-associated liver issues, including transplantation.
Area of Science:
- Gastroenterology and Hepatology
- Clinical Nutrition
- Surgical Innovation
Background:
- Hepatobiliary dysfunction affects up to 90% of patients receiving long-term total parenteral nutrition (TPN).
- Understanding the mechanisms behind TPN-induced liver abnormalities is crucial for patient management.
Purpose of the Study:
- To explore the researched and theoretical causes of hepatobiliary dysfunction in patients on long-term TPN.
- To discuss practical guidelines for managing TPN-associated liver complications.
- To review the role of liver and small bowel transplantation in select cases.
Main Methods:
- Literature review of existing research on TPN-associated hepatobiliary dysfunction.
- Exploration of theoretical possibilities for liver abnormalities.
- Discussion of clinical guidelines and treatment options.
Main Results:
- Long-term TPN is strongly linked to significant hepatobiliary dysfunction.
- Various factors contribute to these liver abnormalities, necessitating proactive management.
- Combined liver and small bowel transplantation is a viable option for specific patient groups.
Conclusions:
- Effective strategies are needed to document, prevent, and treat TPN-induced liver complications.
- Early intervention and tailored management can mitigate severe hepatic consequences.
- Transplantation offers a critical therapeutic avenue for refractory cases.