Is severe liver disease an indication for early transplantation in patients with ultra-short bowel disease?

Long‐Term Outcome of Home Parenteral Nutrition in Patients With Ultra‐Short Bowel Syndrome

“…A series of 5 patients with a median bowel length of 6 cm showed that the prognosis of these patients is good and it is similar to that observed in all other categories of intestinal failure (IF) (11). We have previously described a series of 6 patients with remaining bowel length <20 cm that included 3 cases of U‐SBS and we found that IF‐associated liver disease (IFALD) is the only significant negative prognostic factor that may require referral for ITx (3).…”

“…The median bowel length is 7.5 cm (range [3][4][5][6][7][8][9]. The median follow-up is 5.3 (0.2-11.5) years.…”

“…To date, few data have been reported about pediatric patients with U‐SBS (3–10), with only 2 surveys specifically aiming at evaluating the outcome of long‐term HPN (3,4). A series of 5 patients with a median bowel length of 6 cm showed that the prognosis of these patients is good and it is similar to that observed in all other categories of intestinal failure (IF) (11).…”

Ultrashort Bowel Syndrome in Children

“…From a morbidity standpoint, the patients have required extensive inpatient and outpatient hospital care, including 18 (15-32) ED visits, 113 (89-217) days of inpatient care at our institution, and 11 (7)(8)(9)(10)(11)(12)(13)(14) additional surgical procedures since referral (Table 2). The majority of these operations were related to central venous access.…”

Ultra‐short bowel is an independent risk factor for liver fibrosis in adults with home parenteral nutrition

“…IF-ALD is no more related to the HPN if it is administered according to EPSEN guidelines, 1 since the duration, quantity, composition, frequency, lipids components, including now fish and/or olive oil emulsions and limited amounts of HPN did not influence the development of hepatic fibrosis. Although several independent groups have observed that extensive small intestinal resection was a risk factor of IF-ALD in children,[14][15][16] this has not been reported in adults to date. Our results provide this information and also suggest that there are specific risk factors in adults, such alcohol consumption.The strength of this study was the histological assessment of IF-ALD by two independent experts, describing the kinetics of fibrosis or its regression in relation to the duration of HPN or intestinal restoration (ie, post-transplantation).…”