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 Google Scholar Citing Articles via Scopus Google Scholar Articles by Weseman, R. A. Search for Related Content PubMed PubMed Citation Articles by Weseman, R. A. Social Bookmarking                         What's this?

Review of Incidence and Management of Chylous Ascites After Small Bowel Transplantation

University of Nebraska Medical Center, Intestinal Rehabilitation and Liver/Small Bowel Transplant Programs, Omaha, Nebraska

Correspondence: Correspondence: Rebecca A. Weseman, RD, CNSD, LMNT, University of Nebraska Medical Center, Intestinal Rehabilitation and Liver/Small Bowel Transplant Programs, 983285 Nebraska Medical Center, Omaha, NE 68198-3285. Electronic mail may be sent to Bweseman{at}nebraskamed.com.

Nutrition management of intestinal transplant recipients continues to be a challenging and essential component of the early postoperative care of this patient population. The absorptive capacity of the graft can be affected by immunologic and nonimmunologic factors, including enteric lymphatic disruption, preservation injury, central denervation, viral enteritis, systemic infections, and rejection. Chylous ascites, the extravasation of milky chyle into the peritoneal fluid, defined by elevated triglycerides levels of 200 mg/dL, can occur as a result of trauma, obstruction, or interruption of the lymphatic system. It seems the incidence of chylous ascites after small bowel transplantation is low; however, this may be due in part to the limitation of enteral long-chain triglycerides in the early posttransplant period of 2–6 weeks. After this time frame, clinical evidence suggests that fat assimilation normalizes. In the event that chylous ascites develop as a posttransplant complication, limitation of oral or enteral nutrition support to a very-low-fat regimen may be required, or parenteral nutrition (PN) will need to be provided until clinical status improves. Long-term posttransplant, lymphatic regeneration generally occurs and the majority of intestinal transplant recipients achieve the ultimate goal of nutrition autonomy.

Nutrition in Clinical Practice, Vol. 22, No. 5, 482-484 (2007)
DOI: 10.1177/0115426507022005482


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