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Indications for Intestinal Transplantation.

Kishore R Iyer1

  • 1Intestinal Rehabilitation & Transplant Program, Icahn School of Medicine at Mount Sinai and Mount Sinai Hospital, One Gustave Levy Place, Box 1104, New York 10029, USA.

Gastroenterology Clinics of North America
|May 8, 2024
PubMed
Summary
This summary is machine-generated.

Patients with chronic intestinal failure benefit from specialized care, but those failing parenteral nutrition (PN) are often referred late for intestinal transplantation. A new framework aims for earlier identification and transplantation, improving patient outcomes.

Keywords:
IndicationsIntestinePre-emptiveTransplant

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Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Sciences
  • Transplantation Medicine

Background:

  • Chronic intestinal failure (CIF) management has advanced with multidisciplinary intestinal rehabilitation programs.
  • Improved understanding of CIF complications and novel therapies have enhanced patient survival.
  • Despite progress, late referral for intestinal transplantation remains a challenge for patients with parenteral nutrition (PN)-dependent intestinal failure.

Purpose of the Study:

  • To propose a framework for earlier identification of CIF patients at risk of PN failure.
  • To facilitate earlier consideration for intestinal transplantation in appropriate candidates.
  • To ultimately improve survival outcomes for patients with chronic intestinal failure.

Main Methods:

  • Review of current management strategies for chronic intestinal failure.
  • Analysis of factors contributing to late referral for intestinal transplantation.
  • Development of a proposed framework for risk stratification and timely referral.

Main Results:

  • Current practices often lead to delayed identification of patients requiring intestinal transplantation.
  • A structured approach can identify patients at high risk for PN failure earlier.
  • Earlier transplantation is associated with potentially better patient outcomes.

Conclusions:

  • A proactive framework is needed to optimize the timing of intestinal transplantation referrals.
  • Early identification of PN-failure risk can improve the efficacy of intestinal transplantation.
  • Implementing a rational framework may significantly enhance long-term outcomes for CIF patients.