Visceral transplantation in patients with intestinal-failure associated liver disease: Evolving indications, graft selection, and outcomes

Jason S. Hawksworth*, Chirag S. Desai, Khalid M. Khan, Stuart S. Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M. Fishbein, Cal S. Matsumoto

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations

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.

Original languageEnglish
Pages (from-to)1312-1320
Number of pages9
JournalAmerican Journal of Transplantation
Volume18
Issue number6
DOIs
StatePublished - Jun 2018
Externally publishedYes

Keywords

  • clinical research/practice
  • intestinal (allograft) function/dysfunction
  • intestinal disease
  • intestinal failure/injury
  • intestine/multivisceral transplantation
  • liver (native) function/dysfunction
  • nutrition

Fingerprint

Dive into the research topics of 'Visceral transplantation in patients with intestinal-failure associated liver disease: Evolving indications, graft selection, and outcomes'. Together they form a unique fingerprint.

Cite this