Nutrition in intestinal transplantation: centre stage or supporting act?

Abstract

Purpose of reviewIntestinal transplantation (ITx), whether isolated or combined with other organs, is now a valid treatment option in some patients with chronic intestinal failure or extensive venous mesenteric thrombosis. The aim in these patients is not only to restore nutritional autonomy, but also to minimize the risk of complications, both short and long term. Despite parenteral nutrition playing a central part in the management of intestinal failure patients, there are little data about the perioperative and postoperative nutritional management of ITx patients, due to small patient populations per centre. In this review, we collected the scientific data available to date. Recent findingsIn this review, we will bundle the limited scientific information about diet after intestinal and multivisceral transplantation combined with recommendations from our own clinical practice in 28 ITx patients in University Hospitals Leuven, Belgium. We will discuss the immediate preoperative period, surgical complications necessitating dietary interventions and the late postoperative phase in a stable outpatient transplant recipient.

Nutrition care for the adult post–intestinal transplant patient

“…The prevention of CKD in IF includes providing enough fluid parenterally to accommodate stoma losses as well as supporting kidney function. The prevention of dehydration and protecting kidney function pretransplant is important because immunosuppressive medications posttransplant are nephrotoxic, 38 and lower volume PN infusions have been associated with increased incidence of CKD 39 …”