If your medical condition falls into one of the following categories, you may be a candidate for an intestinal transplant.
TPN related complications
- Parenteral nutrition-induced liver disease. Liver failure is the worst complication induced by parenteral nutrition. An increase in bilirubin, ALT, AST and Alkaline phosphatase may represent the first signs of liver failure. Liver failure is responsible for a large number of deaths caused by intestinal failure.
- Central venous catheter (CVC) related thrombosis of two or more central veins. If you lose access to one or more central veins from thrombosis (or clotted veins) secondary to a parenteral nutrition line, you may be at risk of not being able to access a central line for nutrition and hydration.
- Frequent episodes of central line sepsis. This could include two or more episodes per year of blood stream infection secondary to an infection of a central venous line requiring hospitalization or a single episode of line-related fungemia (infection caused by fungus).
- Frequent episodes of severe dehydration despite intravenous fluid administration in addition to parenteral nutrition.
Underlying disease with an increased risk of morbidity
- Desmoid tumors associated with familial adenomatous polyposis.
- Congenital mucosal disorders (i.e., microvillus inclusion disease, tufting enteropathy).
- Ultra short bowel syndrome (gastrostomy, duodenostomy, residual small bowel <10 cm in infants and <40 cm in adults).
Intestinal failure with intolerance to parenteral nutrition
- Intestinal failure with high morbidity (frequent hospitalization, narcotic dependency) or inability to function (i.e., pseudo-obstruction, high output stoma).
- Patient’s unwillingness to accept long-term home parenteral nutrition (i.e., young patients).