Management Strategies for Patients with Chronic Intestinal Failure Who Are Potential Candidates for a Future Intestinal Transplant / 대한이식학회지

ABSTRACT

Intestinal transplant wait-list mortality is higher than for other organ transplants. This is a review to identify the main problems contributing to the high risk of intestinal transplant candidates and to provide recommendations on how to resolve them. Intestinal transplant, home parenteral nutrition, and intestinal rehabilitation articles issued from the main intestinal transplantation centers from 1987 to 2010 were reviewed. The risk factors for adult and child transplant wait-list mortality were parallel to those of parenteral nutrition. Therefore, primary care givers managing patients with intestinal failure should establish a cooperative link to facilities with active intestinal failure programs from the early period, when anticipation for the parenteral nutrition (PN) requirement is more than 50% in the 3 months of initiation. An intestinal failure care program should include or establish an active collaborative relationship with centers performing intestinal rehabilitation and transplantation. Intestinal rehabilitation centers are expected to establish a multiprofessional team composed of medical doctors, nurses, pharmacists, dieticians, surgeons, gastroenterologists, social workers, fund managers, PN-solution providers, and intestinal transplantation surgeons. National registries for patients undergoing intestinal failure should be established, and home-PN providers should participate.