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Enteral and Parenteral Nutrition: Considerations for Visceral Transplant Patients

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Psychosocial Care of End-Stage Organ Disease and Transplant Patients

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Abstract

Intestinal failure (IF) is a complex malabsorptive disorder that not only leads to multiple health-related complications, but is also closely associated with a reduced quality of life (QOL) due to an intolerance of an oral diet, usually resulting in complete reliance on alternative means of nutrition support. Severe reduction of gut function, impaired intestinal transit time, hypophagia, and almost complete malabsorption of oral macro- and micronutrients are defining characteristics of IF. Due to these complications, patients with IF are often dependent on parenteral nutrition (PN) as the intravenous method for nutrition supplementation to sustain health. Chronic use of PN, however, may result in metabolic and infectious complications. For patients who have irreversible IF and experience complications from PN, multivisceral and intestinal (MV/I) transplantation may be necessary for long-term survival. In addition, protein-calorie malnutrition (PCM) negatively impacts all solid organ and bone marrow transplant outcomes; therefore, a referral to a registered dietitian for nutrition assessment and intervention is crucial to optimize pre-transplant and post-transplant nutrition care. The ultimate goal of MV/I transplantation is to optimize a patient’s QOL by establishing full nutritional autonomy, with a full wean from PN and transition to enteral nutrition (EN) and oral diet.

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Author information

Authors and Affiliations

  1. Intestinal Transplant Program, Digestive Health Center, Stanford Health Care, Palo Alto, CA, USA

    Neha D. Shah MPH, RD, CNSC

  2. Center for Advanced Lung Disease, Stanford Health Care, Palo Alto, CA, USA

    Michelle Stroebe MS, RD

Authors
  1. Neha D. Shah MPH, RD, CNSC
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  2. Michelle Stroebe MS, RD
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Correspondence to Neha D. Shah MPH, RD, CNSC .

Editor information

Editors and Affiliations

  1. Stanford University School of Medicine, Stanford, CA, USA

    Yelizaveta Sher

  2. Stanford University School of Medicine, Stanford, CA, USA

    José R. Maldonado

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Shah, N.D., Stroebe, M. (2019). Enteral and Parenteral Nutrition: Considerations for Visceral Transplant Patients. In: Sher, Y., Maldonado, J. (eds) Psychosocial Care of End-Stage Organ Disease and Transplant Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-94914-7_31

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  • DOI: https://doi.org/10.1007/978-3-319-94914-7_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94913-0

  • Online ISBN: 978-3-319-94914-7

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