Intestinal rehabilitation and transplantation

Abstract

Intestinal failure is a challenging and complicated medical condition resulting in the loss of absorptive surface area or in severe gastrointestinal bacterial overgrowth. Prolonged use of parenteral nutrition (PN) places patients at a risk for multiple complications including catheter related blood stream infection (CRBSI), intestinal failure-associated liver disease (IFALD), and renal impairment. Intestinal rehabilitation programs (IRPs) recently have been recognized to have a significant role in the improvement of outcomes, care coordination, and prevention of complications. Therefore, all patients with permanent intestinal failure should be managed by dedicated multidisciplinary intestinal rehabilitation teams. Under the care of these teams, patients should be considered for intestinal transplantation in the case of progressive IFALD, loss of central venous access, and repeated life-threatening CRBSIs. We herein summarize the current status of IRPs and intestinal transplantation in Japan.