Journal ArticleDOI
Irreversible intestinal failure.
TLDR
The causes of irreversible IF are discussed, the specific medico-surgical strategies for prevention and treatment of these conditions at several stages of IF are emphasized and patients may be candidates for intestinal transplantation.Abstract:
Intestinal failure (IF) can be defined as the reduction of functional gut mass below the minimal amount necessary for digestion and absorption adequate to satisfy the nutrient and fluid requirements for maintenance in adults or growth in children. In developed countries, IF mainly includes individuals with the congenital or early onset of conditions requiring protracted or indefinite parenteral nutrition (PN). Short bowel syndrome was the first commonly recognized cause of protracted IF. The normal physiologic process of intestinal adaptation after extensive resection usually allows for recovery of sufficient intestinal function within weeks to months. During this time, patients can be sustained on parenteral nutrition. Only a few children have permanent intestinal insufficiency and life-long dependency on PN. Non-transplant surgery including small bowel tapering and lengthening may allow weaning from PN in some cases. Hormonal therapy with recombinant human growth hormone has produced poor results while therapy with glucagon-like peptide-2 holds promise. Congenital diseases of enterocyte development such as microvillus inclusion disease or intestinal epithelial dysplasia cause permanent IF for which no curative medical treatment is currently available. Severe and extensive motility disorders such as total or subtotal intestinal agangli-onosis (long segment Hirschsprung disease) or chronic intestinal pseudo-obstruction syndrome may also cause permanent IF. PN and home-PN remain are the mainstays of therapy regardless of the cause of IF. Some patients develop complications while receiving long-term PN for IF especially catheter related complications (thrombosis, sepsis) and liver disease. These patients may be candidates for intestinal transplantation. This review discusses the causes of irreversible IF and emphasizes the specific medico-surgical strategies for prevention and treatment of these conditions at several stages of IF.read more
Citations
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Journal ArticleDOI
1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR).
TL;DR: These Guidelines for Paediatric Parenteral Nutrition have been developed as a mutual project of the European Society for paediatric Gastroenterology, Hepatology and Nutrition and the European society for Clinical Nutrition and Metabolism.
Journal ArticleDOI
ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults.
Loris Pironi,Jann Arends,J.P. Baxter,Federico Bozzetti,Rosa Burgos Pelaez,Cristina Cuerda,Alastair Forbes,Simon M. Gabe,Lyn Gillanders,Mette Holst,Palle Jeppesen,Francisca Joly,Darlene G. Kelly,Stanislaw Klek,Øivind Irtun,S. W. M. Olde Damink,Marina Panisic,Henrik Højgaard Rasmussen,Michael Staun,Kinga Szczepanek,André Van Gossum,Geert J. A. Wanten,Stéphane M. Schneider,Jon Shaffer +23 more
TL;DR: This project developed a formal definition and classification of IF, which will facilitate communication and cooperation among professionals in clinical practice, organization and management, and research.
Journal ArticleDOI
2003 report of the intestine transplant registry: a new era has dawned.
David R. Grant,Kareem Abu-Elmagd,Jorge Reyes,Andreas G. Tzakis,Alan Norman Langnas,Thomas M. Fishbein,Olivier Goulet,Douglas G. Farmer +7 more
TL;DR: Transplantation is an effective therapy for the treatment of patients with end-stage intestine failure who cannot tolerate parenteral nutrition and with newer immune suppressive protocols, 1-year graft and patient survival rates approach the results of liver transplantation.
Journal ArticleDOI
Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.
Robert H. Squires,Christopher Duggan,Daniel H. Teitelbaum,Paul W. Wales,Jane Balint,Robert S. Venick,Sue Rhee,Debra L. Sudan,David F. Mercer,J. Andres Martinez,Beth A. Carter,Jason S. Soden,Simon Horslen,Jeffrey A. Rudolph,Samuel A. Kocoshis,Riccardo A. Superina,Sharon Lawlor,Tamara Haller,Marcia Kurs-Lasky,Steven H. Belle +19 more
TL;DR: The Pediatric Intestinal Failure Consortium performed a retrospective analysis of clinical and outcome data for a multicenter cohort of infants with IF to characterize the natural history of intestinal failure among 14 pediatric centers during the intestinal transplantation era.
Journal ArticleDOI
ESPEN Guidelines on Parenteral Nutrition: home parenteral nutrition (HPN) in adult patients.
Michael Staun,Loris Pironi,Federico Bozzetti,J.P. Baxter,Alastair Forbes,Francesca Joly,Palle Jeppesen,José Moreno,Xavier Hébuterne,Marek Pertkiewicz,Stefan Mühlebach,Alan Shenkin,André Van Gossum +12 more
TL;DR: The purpose of these guidelines is to highlight areas of good practice and promote the use of standardized treatment protocols between centers, and may serve as a framework for development of policies and procedures.
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Journal ArticleDOI
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Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.
Robert H. Squires,Christopher Duggan,Daniel H. Teitelbaum,Paul W. Wales,Jane Balint,Robert S. Venick,Sue Rhee,Debra L. Sudan,David F. Mercer,J. Andres Martinez,Beth A. Carter,Jason S. Soden,Simon Horslen,Jeffrey A. Rudolph,Samuel A. Kocoshis,Riccardo A. Superina,Sharon Lawlor,Tamara Haller,Marcia Kurs-Lasky,Steven H. Belle +19 more