title: Review on hepatic explant pathology of pediatric intestinal transplant recipients: Is it time for an oil change?
abstract: A recent study attempts to add to the body of evidence that is emerging regarding the fish oil parenteral lipid product Omegaven™. The authors have shown from explant livers of children on chronic parenteral nutrition with Omegaven™ that biochemical improvement in cholestasis does not always reflect improvement in liver histology. These findings support 2 small case series that were previously published. Despite improvement and resolution of hyperbilirubinemia in all six infants, five of six infants had persistent or progressive hepatic fibrosis, while only one infant had regression of fibrosis. The study raises questions of whether there is a window of opportunity for efficacy of this preparation; also, an important question is if this omega-3 fatty acid-rich preparation is superior to newer "blended lipids" containing olive, coconut, soy, and fish oil.
authors.affiliation: Essam Imseis, J Marc Rhoads, Department of Pediatrics, Divisions of Gastroenterology and Hepatology, University of Texas Medical School at Houston, Houston, TX 77030, United States.
authors.forename: Essam
authors.initials: E
authors.lastname: Imseis
authors.affiliation: Essam Imseis, J Marc Rhoads, Department of Pediatrics, Divisions of Gastroenterology and Hepatology, University of Texas Medical School at Houston, Houston, TX 77030, United States.
authors.forename: J Marc
authors.initials: JM
authors.lastname: Rhoads
mesh_terms: D005217:Fat Emulsions, Intravenous; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D006932:Hyperbilirubinemia / Q000628:therapy*; D007410:Intestinal Diseases / Q000628:therapy*; D007422:Intestines / Q000637:transplantation*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils
keywords: Intralipid; Omega-3 fatty acid; Omegaven; Parenteral nutrition; Short bowel syndrome