Some new insights in intestinal failure-associated liver disease

Curr Opin Organ Transplant. 2009 Jun;14(3):256-61. doi: 10.1097/MOT.0b013e32832ac06f.


Purpose of review: To point new insights in the cholestasis that is a complication of both intestinal failure and parenteral nutrition. View on liver disease has recently evolved with the onset of fish oil-based intravenous lipid emulsions (ILE).

Recent findings: Focused on the role of ILE in causing liver disease. Reversal of cholestasis was recently achieved in infants with short bowel syndrome, by replacing the 'reference' soybean oil-based ILE by fish oil-based ILE.

Summary: It is likely that this reversal involves several factors such as the change in n-6: n-3 ratio, the reduction in phytosterol load, the increased provision of alpha-tocopherol as antioxidant agent. Alternative issue might be based on the use of a new generation of ILE aiming to provide n-3 and to reduce n-6 fatty acids load while enhancing alpha-tocopherol intake. New data are based on the use of an ILE containing a balanced proportion of four types of oil as a physical mixture of 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil and 15% fish oil with amounts of alpha-tocopherol calculated according to the number of double bonds. This new emulsion was reported to be beneficial in reversing or preventing liver disease.

Publication types

  • Review

MeSH terms

  • Cholestasis / etiology
  • Cholestasis / therapy*
  • Fat Emulsions, Intravenous / adverse effects
  • Fat Emulsions, Intravenous / therapeutic use*
  • Fish Oils / adverse effects
  • Fish Oils / therapeutic use*
  • Humans
  • Infant
  • Infant, Newborn
  • Intestinal Diseases / complications
  • Intestinal Diseases / therapy*
  • Liver Diseases / etiology
  • Liver Diseases / prevention & control*
  • Liver Transplantation
  • Parenteral Nutrition, Total / adverse effects*
  • Risk Factors
  • Short Bowel Syndrome / complications
  • Short Bowel Syndrome / therapy*
  • Soybean Oil / adverse effects
  • Soybean Oil / therapeutic use*


  • Fat Emulsions, Intravenous
  • Fish Oils
  • Soybean Oil