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Prevalence of liver complications in children receiving long-term parenteral nutrition

B Peyret1, S Collardeau, S Touzet

  • 1Pediatric department CHR Annecy, Lyon, France.

European Journal of Clinical Nutrition
|March 24, 2011
PubMed

Insights

Long-term home total parenteral nutrition (TPN) in children leads to significant liver abnormalities, including fibrosis. Younger age, longer TPN duration, and infections are identified risk factors for these hepatic issues.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Clinical Nutrition

Background:

  • Long-term home total parenteral nutrition (TPN) is critical for children with intestinal failure.
  • Hepatic complications are a concern in pediatric TPN, but data on long-term outcomes are limited.

Purpose of the Study:

  • To investigate the hepatic prognosis in children dependent on long-term home TPN.
  • To analyze risk factors associated with biochemical and histological liver abnormalities in this population.

Main Methods:

  • Retrospective review of 42 children on home TPN for over 2 years.
  • Analysis of hepatic biochemical parameters and detailed classification of liver biopsies by two pathologists.

Main Results:

  • 57% of patients developed biochemical liver abnormalities, associated with younger age at TPN start, longer TPN duration, infections, and higher TPN volume/energy.
  • 94% of biopsied patients showed fibrosis; risk factors included shorter bowel length and longer TPN duration.
  • Cholestasis correlated with lower lipid energy intake; steatosis had no identified risk factors.

Conclusions:

  • Very long-term home TPN in children is associated with a high incidence of histological liver abnormalities.
  • Identified risk factors provide insights for monitoring and potentially mitigating TPN-induced liver disease in pediatric patients.
Abstract

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