This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Matarese, L. E. Articles by Abu-Elmagd, K. Search for Related Content PubMed PubMed Citation Articles by Matarese, L. E. Articles by Abu-Elmagd, K. Social Bookmarking                         What's this?

Therapeutic Efficacy of Intestinal and Multivisceral Transplantation: Survival and Nutrition Outcome

Laura E. Matarese, PhD, RD, LDN, FADA, CNSD^*
Guilherme Costa, MD^*
Geoffrey Bond, MD^*
June Stamos, RN, BSN, CCTC^*
Darlene Koritsky, RN^*
Stephen J. D. O'Keefe, MD, MSc, FRCP
Kareem Abu-Elmagd, MD, PhD, FACS^*

^* Intestinal Rehabilitation and Transplantation Center, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and the Division of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Correspondence: Correspondence: Laura E. Matarese, PhD, RD, LDN, FADA, CNSD, Thomas E. Starzl Transplantation Institute, Intestinal Rehabilitation and Transplantation Center, UPMC Montefiore, 7 South, 3459 Fifth Avenue, Pittsburgh, PA 15213. Electronic mail may be sent to mataresele{at}upmc.edu.

The clinical introduction of intestinal transplantation has added a new dimension and offered a valid therapeutic option for patients with irreversible intestinal failure. In the year 2000, the Center for Medicare & Medicaid Services (CMS) recognized intestinal, combined liver-intestinal, and multivisceral transplantation as the standard of care for patients with irreversible intestinal and parenteral nutrition (PN) failure. Accordingly, the indications for the procedure are currently limited to those who develop life-threatening PN complications. However, a recent improvement in survival similar to other solid organ transplant recipients should justify lifting the current restricted criteria, and the procedure should be considered before the development of PN failure. Equally important is the awareness of the recent evolution in nutrition management and outcome after transplantation. Early and progressive enteral feeding using a complex polymeric formula is safe and effective after successful transplantation. Full nutrition autonomy is universally achievable among most intestinal and multivisceral recipients, with enjoyment of unrestricted oral diet. Such a therapeutic benefit is commonly maintained among long-term survivors, with full rehabilitation and restoration of quality of life.

Nutrition in Clinical Practice, Vol. 22, No. 5, 474-481 (2007)
DOI: 10.1177/0115426507022005474


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. E Matarese, I. Dvorchik, G. Costa, G. J Bond, D. A Koritsky, R. P Ferraris, R. Touger-Decker, J. K O'Sullivan-Maillet, and K. M Abu-Elmagd Pyridoxal-5'-phosphate deficiency after intestinal and multivisceral transplantation Am. J. Clinical Nutrition, January 1, 2009; 89(1): 204 - 209. [Abstract] [Full Text] [PDF]