Management of intestinal failure in inflammatory bowel disease: small intestinal transplantation or home parenteral nutrition?

World J Gastroenterol. 2014 Mar 28;20(12):3153-63. doi: 10.3748/wjg.v20.i12.3153.

Abstract

Inflammatory bowel disease and Crohn's disease in particular, is a common cause of intestinal failure. Current therapeutic options include home parenteral nutrition and intestinal transplantation. For most patients, home intravenous therapy including parenteral nutrition, with a good probability of long-term survival, is the favoured choice. However, in selected patients, with specific features that may shorten survival or complicate home parenteral nutrition, intestinal transplantation presents a viable alternative. We present survival, complications, quality of life and economic considerations that currently influence individualised decision-making between home parenteral nutrition and intestinal transplantation.

Keywords: Complications; Crohn’s disease; Home parenteral nutrition; Inflammatory bowel disease; Intestinal failure; Intestinal transplantation; Quality of life; Survival.

Publication types

  • Review

MeSH terms

  • Catheterization / adverse effects
  • Crohn Disease / therapy
  • Humans
  • Inflammatory Bowel Diseases / therapy*
  • Intestine, Small / transplantation*
  • Liver Diseases / complications
  • Parenteral Nutrition, Home*
  • Postoperative Complications
  • Quality of Life
  • Recurrence
  • Sepsis
  • Treatment Outcome