In 2002, the Italian guidelines for eligibility of patients for intestinal transplantation (ITx) were defined as: life-threatening complications of home parenteral nutrition (HPN), lack of venous access for HPN, locally invasive tumors of the abdomen, Chronic intestinal failure (CIF) with a high risk of mortality, primary disease-related poor quality of life (QoL) despite optimal HPN. Our aim was to identify potential candidates for ITx according to these national guidelines among patients managed by a medical referral center for CIF. Records of patients who received HPN were reviewed. CIF was considered reversible or irreversible (energy by HPN <50% or >50% basal energy expenditure). Patients with irreversible CIF were considered eligible for ITx in the absence of a contraindication, as are used for solid organs Tx. From 1986 to 2003 among 64 patients who met the entry criteria 23 showed reversible and 41 irreversible, CIF. Twenty-one patients with irreversible CIF had an indication for ITx, but eight had also contraindications; thus 13 were eligible, including intestinal pseudo-obstruction (n = 6), mesenteric ischemia (n = 3), Crohn's (n = 2), radiation enteritis (n = 1), and desmoid (n = 1). Indications for ITx included HPN liver failure (n = 2), lack of venous access (n = 2), CIF with high risk of mortality (n = 3), very poor QoL (n = 6 including 5 with pseudo-obstruction). According to the Italian guidelines for ITx, 31% of patients with irreversible CIF managed by a medical referral center were eligible for ITx. Primary disease-related poor QoL was the indication in half of them. Studies on the QoL after ITx are required to allow patients to make an educated decision.

Italian guidelines for intestinal transplantation: potential candidates among the adult patients managed by a medical referral center fro chronic intestinal failure / L., Pironi; G., Spinucci; F., Paganelli; C., Merli; Masetti, Michele; M., Miglioli; A. D., Pinna. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - 36:3(2004), pp. 659-661. [10.1016/j.transproceed.2004.03.004]

Italian guidelines for intestinal transplantation: potential candidates among the adult patients managed by a medical referral center fro chronic intestinal failure.

MASETTI, Michele;
2004

Abstract

In 2002, the Italian guidelines for eligibility of patients for intestinal transplantation (ITx) were defined as: life-threatening complications of home parenteral nutrition (HPN), lack of venous access for HPN, locally invasive tumors of the abdomen, Chronic intestinal failure (CIF) with a high risk of mortality, primary disease-related poor quality of life (QoL) despite optimal HPN. Our aim was to identify potential candidates for ITx according to these national guidelines among patients managed by a medical referral center for CIF. Records of patients who received HPN were reviewed. CIF was considered reversible or irreversible (energy by HPN <50% or >50% basal energy expenditure). Patients with irreversible CIF were considered eligible for ITx in the absence of a contraindication, as are used for solid organs Tx. From 1986 to 2003 among 64 patients who met the entry criteria 23 showed reversible and 41 irreversible, CIF. Twenty-one patients with irreversible CIF had an indication for ITx, but eight had also contraindications; thus 13 were eligible, including intestinal pseudo-obstruction (n = 6), mesenteric ischemia (n = 3), Crohn's (n = 2), radiation enteritis (n = 1), and desmoid (n = 1). Indications for ITx included HPN liver failure (n = 2), lack of venous access (n = 2), CIF with high risk of mortality (n = 3), very poor QoL (n = 6 including 5 with pseudo-obstruction). According to the Italian guidelines for ITx, 31% of patients with irreversible CIF managed by a medical referral center were eligible for ITx. Primary disease-related poor QoL was the indication in half of them. Studies on the QoL after ITx are required to allow patients to make an educated decision.
2004
36
3
659
661
Italian guidelines for intestinal transplantation: potential candidates among the adult patients managed by a medical referral center fro chronic intestinal failure / L., Pironi; G., Spinucci; F., Paganelli; C., Merli; Masetti, Michele; M., Miglioli; A. D., Pinna. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - 36:3(2004), pp. 659-661. [10.1016/j.transproceed.2004.03.004]
L., Pironi; G., Spinucci; F., Paganelli; C., Merli; Masetti, Michele; M., Miglioli; A. D., Pinna
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/310753
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