• L Pironi, F Paganelli, A M M Labate, C Merli, C Guidetti, G Spinucci, and M Miglioli.
• Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy. loris.pironi@med.unibo.it
• Dig Liver Dis. 2003 May 1; 35 (5): 314-24.

BackgroundComparisons between safety and efficacy of home parenteral nutrition and of intestinal transplantation for treatment of chronic intestinal failure derived from observational studies.AimsTo present the 16-year experience of home parenteral nutrition by the Chronic Intestinal Failure Centre of Bologna University.PatientsA total of 40 adult patients were enrolled between 1986 and 2001.MethodsSafety indices: survival and cause of death, catheter-related bloodstream infection, deep vein thrombosis, liver disease. Efficacy indices: nutritional and rehabilitation status, quality of life (SF36 instrument), re-hospitalisation rate.StatisticsKaplan-Maier analysis and Cox model for survival probability and risk factors; logistic regression for catheter-related bloodstream infection risk factors.ResultsSurvival rates at 1, 3 and 5 years were 97, 82 and 67% respectively. Survival was higher in patients < or = 40 years. One death was home parenteral nutrition-related. Incidence of catheter-related bloodstream infection: 0.30/year home parenteral nutrition, was lower in patients treated by a specialized nursing protocol. Incidence of deep vein thrombosis was 0.05/year home parenteral nutrition. Hepatosteatosis occurred in 55%. Body weight remained stable or increased in 80%. Rehabilitation was total or partial in 74%. Re-hospitalisation rate was 0.70/year home parenteral nutrition. Quality of life scored significantly lower than in healthy populations in six out of eight domains.ConclusionsHome parenteral nutrition is a safe and efficacious therapy for chronic intestinal failure. Survival compares favourably with survival after intestinal transplantation.

18 keywords...

hide…