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Published on: August 20, 2007
Intestinal transplantation in infants with intestinal failure
Richard S Mangus1, Girish C Subbarao
1Transplant Division, Department of Surgery, Indiana University School of Medicine, 550 North University Boulevard, Room 4601, Indianapolis, IN 46202-5250, USA. rmangus@iupui.edu
Insights
Intestinal failure (IF) requires parenteral nutrition (PN) and may necessitate intestinal transplantation (IT). Early IT referral is crucial to avoid complications that could disqualify patients from this life-saving therapy.
Area of Science:
- Gastroenterology
- Transplantation Surgery
- Clinical Nutrition
Background:
- Intestinal failure (IF) is a critical condition where the intestine cannot adequately absorb nutrients.
- Parenteral nutrition (PN) is a common treatment for IF, but carries risks of complications.
- Intestinal transplantation (IT) offers a solution for patients with IF refractory to conventional therapies.
Purpose of the Study:
- To highlight the critical role of intestinal transplantation (IT) in managing complex intestinal failure (IF).
- To emphasize the importance of timely referral for IT to improve patient outcomes.
- To discuss the implications of PN-related complications on IT eligibility.
Main Methods:
- Review of clinical outcomes for intestinal transplantation (IT).
- Analysis of patient eligibility criteria for IT.
- Evaluation of complications associated with long-term parenteral nutrition (PN).
Main Results:
- Intestinal transplantation (IT) outcomes have significantly improved, establishing it as a standard care for select IF patients.
- Complications from prolonged parenteral nutrition (PN) can preclude patients from IT candidacy.
- Delayed IT referral increases the risk of complications and potential ineligibility.
Conclusions:
- Intestinal transplantation (IT) is a viable and increasingly successful treatment for intestinal failure (IF).
- Optimizing the timing of IT referral is paramount to maximize success rates and avoid PN-related complications.
- Multidisciplinary management is essential for patients with IF requiring PN and considering IT.
Abstract:
Intestinal failure (IF) occurs when a person's functional intestinal mass is insufficient. Patients with IF are placed on parenteral nutrition (PN) while efforts are made to restore intestinal function through surgical or medical intervention. Patients who fail standard IF therapies may be candidates for intestinal transplantation (IT). Clinical outcomes for IT have improved to make this therapy the standard of care for patients who develop complications of PN. The timing of referral for IT is critical because accumulated complications of PN can render the patient ineligible for IT or can force the patient to await multiorgan transplantation.
