Visceral transplantation in patients with intestinal-failure associated liver disease: Evolving indications, graft selection, and outcomes.
Am J Transplant
; 18(6): 1312-1320, 2018 06.
Article
en En
| MEDLINE
| ID: mdl-29498797
ABSTRACT
Intestinal failure (IF)-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with IF. Visceral transplant for IFALD includes variants of intestine, liver, or combined liver-intestine allografts. Graft selection for an individual patient depends on the etiology of IF, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation. The past decade has witnessed dramatic improvement in the management of IFALD, principally due to improved lipid emulsion formulations and the multidisciplinary care of the patient with IF. As the recognition and treatment of IFALD continue to improve, the requirement of liver-inclusive visceral grafts appears to be decreasing, representing a paradigm shift in the care of the patient with IF. This review highlights the current indications, graft selection, and outcomes of visceral transplantation for IFALD.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Vísceras
/
Enfermedades Intestinales
/
Hepatopatías
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos