Management of intestinal failure in inflammatory bowel disease: small intestinal transplantation or home parenteral nutrition?
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.
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Elizabeth
E
Harrison
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Philip
P
Allan
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Amrutha
A
Ramu
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Anil
A
Vaidya
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Simon
S
Travis
Elizabeth Harrison, Philip Allan, Amrutha Ramu, Simon Lal, Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Greater Manchester M6 8HD, United Kingdom.
Simon
S
Lal
D002404:Catheterization / Q000009:adverse effects; D003424:Crohn Disease / Q000628:therapy; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D007421:Intestine, Small / Q000637:transplantation*; D008107:Liver Diseases / Q000150:complications; D016331:Parenteral Nutrition, Home; D011183:Postoperative Complications; D011788:Quality of Life; D012008:Recurrence; D018805:Sepsis; D016896:Treatment Outcome
Complications; Crohn’s disease; Home parenteral nutrition; Inflammatory bowel disease; Intestinal failure; Intestinal transplantation; Quality of life; Survival