Prognosis of patients with nonmalignant chronic intestinal failure receiving long-term home parenteral nutrition

Messing, Bernard; Lémann, Marc; Landais, Paul; Gouttebel, M. C.; Gerard-Boncompain, M.; Saudin, F.; Vangossum, A.; Beau, Philippe; Guédon, Claire; Barnoud, D.; Beliah, M.; Joyeux, H; Boulétreau, P; Robert, Dominique; Matuchansky, C; Leverve, Xavier; Lerebours, Éric; Carpentier, Yvon; Rambaud, Jean–Claude

doi:10.1016/0016-5085(95)90196-5

Cited by 206 publications

(99 citation statements)

References 16 publications

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“…78% of those who survive with the transplant are able to stop parenteral nutrition. These figures contrast to those for patients on home parenteral nutrition for non-neoplastic reasons who can expect to have a relatively good quality of life good and a survival rate of 70% at 3 years [223,224] .…”

Section: New and Future Treatmentsmentioning

confidence: 65%

Management of patients with a short bowel

Nightingale

1999

Nutrition

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Section: New and Future Treatmentsmentioning

confidence: 65%

Management of patients with a short bowel

Nightingale

1999

Nutrition

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“…46,48,49,83,152,[156][157][158] Survival is principally determined by underlying disease; patients with inflammatory bowel disease for example demonstrate a high 5-year survival of 92%, 157 whereas patients with motility disorders have the poorest 5-year survival at 48%. 157 Multivariate analysis of survival data from single centres has also demonstrated lower survival rates in patients with end-enterostomies 156,158 or a small bowel length of <50 cm. 156 The survival of patients receiving PN for advanced malignancy is poor with median time to death of between 5 and 6.5 months.…”

Section: Survivalmentioning

confidence: 99%

“…157 Multivariate analysis of survival data from single centres has also demonstrated lower survival rates in patients with end-enterostomies 156,158 or a small bowel length of <50 cm. 156 The survival of patients receiving PN for advanced malignancy is poor with median time to death of between 5 and 6.5 months.…”

Section: Survivalmentioning

confidence: 99%

Review article: the management of long‐term parenteral nutrition

Dibb

Teubner

Theis

et al. 2013

Aliment Pharmacol Ther

137

108

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SummaryBackgroundHome parenteral nutrition (HPN) is currently the management of choice for patients with chronic intestinal failure.AimTo summarise the major issues in delivering long‐term parenteral nutrition (>3 months) and assess outcome as per complications, mortality and quality of life. To assess the evidence for the therapeutic use of trophic factors such as teduglutide and to review evolving therapeutic options in the treatment of chronic intestinal failure.MethodsA literature search using PubMed and MEDLINE databases was performed.ResultsSafe delivery of HPN relies upon individualised formulations of parenteral nutrition administered via carefully maintained central venous catheters by trained patients or carers, supported by a skilled multidisciplinary team. Early diagnosis and treatment of complications including catheter‐associated blood stream infection (reported incidence 0.14–0.83 episodes/patient‐year on HPN) and central venous thrombosis (reported incidence 0.03 episodes/patient‐year) is important to minimise mortality and morbidity. There is a significant variation in the reported incidence of both hepatobiliary complications (19–75%) and advanced liver disease (0–50%). Five‐year survival rates in large centres are reported between 60% and 78% with survival primarily related to underlying diagnosis. Long‐term survival remains higher on HPN than with intestinal transplantation. The role of intestinal lengthening procedures is yet to be validated in adults.ConclusionsHome parenteral nutrition delivered by skilled nutrition teams has low incidences of catheter‐related complications. Most deaths relate to the underlying disease. Therapies such as teduglutide and small bowel transplantation appear promising, but home parenteral nutrition appears likely to remain the bedrock of management in the near term.

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“…achieving enteral autonomy) and decreasing rates and progression of intestinal failure-associated liver disease (IFALD) and other life-threatening complications in patients remaining on PN. Historically, life-threatening complications and the underlying disease led to mortality of up to 38% within 2-5 years following the development of intestinal failure (3)(4)(5)(6). In a contemporary series, for patients without complications marked improvement in survival was demonstrated with 87% of PN-dependent patients achieving 5-year patient survival (7).…”

Section: Purpose Of Reviewmentioning

confidence: 99%

The Current State of Intestine Transplantation: Indications, Techniques, Outcomes and Challenges

Sudan

2014

American Journal of Transplantation

111

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Intestine transplantation is the least common form of organ transplantation in the United States and often deemed one of the most difficult. Patient and graft survival have historically trailed well behind other organ transplants. Over the past 5-10 years registry reports and single center series have demonstrated improvements to patient survival after intestinal transplantation that now match patient survival for those without life-threatening complications on parenteral nutrition. For various reasons including improvements in medical care of patients with intestinal failure and difficulty accessing transplant care, the actual number of intestine transplants has declined by 25% over the past 6 years. In light of the small numbers of intestine transplants, many physicians and the lay public are often unaware that this is a therapeutic option. The aim of this review is to describe the current indications, outcomes and advances in the field of intestine transplantation and to explore concerns over future access to this important and life-saving therapy.

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Prognosis of patients with nonmalignant chronic intestinal failure receiving long-term home parenteral nutrition

Cited by 206 publications

References 16 publications

Management of patients with a short bowel

Management of patients with a short bowel

Review article: the management of long‐term parenteral nutrition

The Current State of Intestine Transplantation: Indications, Techniques, Outcomes and Challenges

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