950 Effects of Probiotics on Intestinal Failure-Associated Liver Disease in Adult Patients Receiving Prolonged Parenteral Support: A Tertiary Care Center Experience

Abstract

INTRODUCTION: It has been hypothesized that dysbiosis plays a significant role in the pathogenesis of intestinal failure-associated liver disease (IFALD). Therefore, we aimed to investigate the effect of probiotics on IFALD in patients receiving prolonged parenteral support, namely home parenteral nutrition (HPN) and intravenous fluids (HIVF). METHODS: We identified a cohort of patients with intestinal failure (IF) who received HPN or HIVF for >2 weeks at our tertiary center between January 2005 and August 2016. (Table 1) We excluded patients < 18 years of age, patients with other causes of liver disease, patients who used probiotics for < 30 days, patients with < 6 months follow up and those who had long-term antibiotic use ( >30 days). Bivariable and multivariable logistic regression analyses were used in this study. RESULTS: A total of 282 patients who received prolonged parenteral support were included. Eighty-five percent of our sample received PN, while the remaining got HIVF. A total of 78 (27.7%) patients used probiotics. The prevalence of IFALD in patients who used probiotic was 35.9% vs. 54.4% in patients who did not use probiotics, P = 0.005. In multivariable analysis, only small bowel length of 10-90 cm and HPN use showed a significant impact on IFALD, OR = 4.114 (95% CI = 1.557-10.874, P = 0.004), OR = 4.164 (95% CI = 1.325-13.087, P = 0.015) respectively (Table 2). CONCLUSION: Our data does not support the use of probiotics to prevent IFALD in patients receiving prolonged parenteral support. Only small bowel length of 10-90 cm and prolonged HPN use showed a significant impact on IFALD.