Abstract
This review summarizes the latest epidemiologic data, and indications and methods for preventing complications from home parenteral nutrition (HPN), and it discusss survival, prognosis and quality of life of HPN patients who are potential candidates for intestinal transplantation. Although alteration in hepatic enzymes is frequent with HPN, severe HPN-related liver disorders are rare because of improvements in nutritional support. In experienced centres, likelihood of survival in HPN patients may reach 86% and 71% at 1 and 10 years, respectively. About 15% of adult HPN patients are potential candidates for intestinal transplantation. Complications include catheter-related sepsis and thrombosis, metabolic disorders, nutritional deficiency, psychological alteration and rehabilitation problems. Recent studies found that catheters lasted for 1.5 years on average. Alteration in hepatic enzymes alterations is frequent but severe liver complications are rare. Bone alterations occur in 75% of HPN patients, with multifactorial aetiology. Lipid administration should not exceed 1 g/kg per day. Overall probability of survival is good at 1 and 10 years; 10% of deaths are due to HPN complications. A large survey in European centres revealed that 15% of adults and 34% of children are candidates for intestinal transplantation.
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