Nutrition support after intestinal transplantation: how important is enteral feeding?

Abstract:

PURPOSE OF REVIEW:Intestinal transplantation is the alternative treatment in patients with irreversible intestinal failure, who depend on long-term parenteral nutrition. Nutrition management after intestinal transplantation should contribute to reducing the risk of graft rejection, to improving gut trophicity and should optimize nutrient absorption, the main goal being to achieve full intestinal autonomy. RECENT FINDINGS:Enteral feeding can be administered into the stomach, or directly into the jejunum. Semi-elemental diets are usually used with the aim of improving nutrient absorption and limiting food antigen overload, which might trigger immune stimulation with subsequent increased risk of acute graft rejection. There is no evidence-based reason to use amino acid-based formula. The feeding usually starts with a dilute semi-elemental formula and with a low rate of delivery. The rate and strength of the formula are slowly increased thereafter, according to the individual tolerance. Chylous ascitis and fat malabsorption impair both short-term and long-term nutritional results and are likely to be due to an insufficient reestablishment of the lymphatic circulation of the graft. After an intestinal transplant, patients usually achieve linear growth. However, catch-up growth is rarely observed in stunted patients. SUMMARY:Nutritional management after intestinal transplantation is challenging and requires a trained, specialized multidisciplinary team.

authors

Colomb V,Goulet O

doi

10.1097/mco.0b013e328323280f

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

186-9

issue

2

eissn

1363-1950

issn

1473-6519

journal_volume

12

pub_type

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