Intestinal Failure Diagnosis, Management and Transplantation

by Langnas, Alan; Goulet, Olivier; Quigley, Eamonn M. M.; Tappenden, Kelly A.

• ISBN13: 9781405146371
• ISBN10: 1405146370
• Edition: 1st
• Format: Hardcover
• Copyright: 2008-03-10
• Publisher: Wiley-Blackwell

Summary

Intestinal failure is a challenging, emerging field that has been the subject of much research and debate in recent years and has only recently become widely accepted as a distinct clinical syndrome.This comprehensive book provides an in-depth review of scientific theory and clinical practice relating to intestinal failure with specific emphasis on assessment and management as part of a multidisciplinary team. Compiled by an internationally recognised editorial team, the book provides a practical how-to guide to the management of adult and pediatric patients with intestinal failure, focusing on quality-of-life issues that are at the heart of patient care. World experts from centers of excellence share their clinical experience and expertise, offering the first ever authoritative resource on intestinal failure All aspects of patient management are covered, from diagnosis and medical and surgical management (including transplantation) to nutritional consideration and psychosocial aspects of care Numerous illustrations, flow diagrams and summary boxes complement the text and emphasize important concepts, providing an accessible approach to this complex fieldThis landmark book is essential reading for any gastroenterologists, surgeons, transplant teams or clinical nutritionists involved in the care of patients with intestinal failure.

Author Biography

Alan N. Langnas, DO is Chief of Transplantation and Director of the Liver and Intestinal Transplantation Program at the University of Nebraska Medical Center, Omaha, USA. Professor Langnas has been doing liver transplants at UNMC since 1988 and over the past seven years has performed more than 40 intestinal and intestinal/liver transplants, establishing the UNMC program as one of the top transplant centers in the world performing multiple organ transplants. Along side his transplant work, Professor Langnas also maintains an active practice treating non-transplant hepato-biliary patients and serves on the editorial boards of several medical journals. In addition to writing more than 100 research papers for medical journals, he is also active in several capacities with the United Network for Organ Sharing, the national organ allocation system in the U.S.

Olivier Goulet, MD, PhD Pediatric Gastroenterology-Hepatology and Nutrition, Reference Center for Rare Digestive Diseases, Integrated Program of Intestinal Failure, Home Parenteral Nutrition and Intestinal Transplantation, University of Paris-Descartes, Necker Hospital, Paris, France.

Eamonn M.M. Quigley, MD, FRCP, FACP, FACG, FRCPI is Professor of Medicine and Human Physiology and Head of the Medical School at the National University of Ireland (NUI), Cork. He also serves as Adjunct Professor of Medicine and Physiology at the University of Nebraska Medical Center in Omaha, USA. He is Editor-in-Chief of the American Journal of Gastroenterology and Vice-President of the World Organization of Gastroenterology (OMGE - Organisation Mondiale de Gastroentérologie). His major research interests are in the areas of motility, functional gastrointestinal disorders and gastrointestinal dysfunction in systemic disease. He has published over 400 original papers, reviews, editorials and book chapters and has received numerous awards from universities and societies worldwide.

Kelly A. Tappenden, PhD, RD is Associate Professor of Nutrition and Gastrointestinal Physiology in the Division of Nutritional Sciences at the University of Illinois at Urbana-Champaign, USA. Professor Tappenden recently received the 2005 American Society of Parenteral and Enteral Nutrition Dudrick Research Scholar Award and the 2004 College of Agricultural, Consumer and Environmental Sciences Faculty Award for Excellence in Research. Professor Tappenden’s research interests include the regulation of small intestinal function by various nutrients and gastrointestinal-specific pepides. Her recent publications are featured in the Journal of Parenteral and Enteral Nutrition, Journal of Pediatric Gastroenterology and Nutrition and Journal of Nutrition. In addition to her academic research, Professor Tappenden is also a Registered Dietician, having completed clinical training at the Misericordia Hospital in Edmonton, Alberta.

Table of Contents

List of Contributors	p. viii
Foreword	p. xiii
Preface	p. xvii
Abbreviations	p. xix
Introduction
The History of Intestinal Failure and Transplantation	p. 3
Intestinal Physiology and Immunology
Intestinal Morphology, Intestinal Regeneration and the Promise of Tissue Engineering	p. 13
Basic Physiology of Motility, Absorption and Secretion	p. 20
Immunology of the Small Intestine	p. 33
Intestinal Adaptation: The Biology of the Intestinal Response to Resection and Disease	p. 45
Intestinal Failure: Definition and Pathophysiology
Intestinal Failure: Definitions and Classifications	p. 57
Causes of Intestinal Failure in the Newborn	p. 66
Congenital Enteropathies Causing Permanent Intestinal Failure	p. 77
Causes of Intestinal Failure in the Adult	p. 88
Intestinal Failure Related to Bariatric Surgery	p. 93
Inflammatory Bowel Disease and the Short Bowel Syndrome	p. 99
Motility Disorders	p. 107
Assessment and General Management of Intestinal Failure
Assessment of Intestinal Failure Patients	p. 117
Guidelines for Home Parenteral Nutrition Support in Chronic Intestinal Failure Patients	p. 122
Home Parenteral Nutrition: Complications, Survival, Costs and Quality of Life	p. 130
Vascular Access, Including Complications	p. 142
Enteral Support for Children with Intestinal Failure	p. 151
The Use of Enteral Nutrition in the Adult with Intestinal Failure	p. 160
The Enteric Flora in Intestinal Failure: Small Intestinal Bacterial Overgrowth and Gut-Derived Sepsis	p. 167
Management of Complex Fluid and Electrolyte Disturbances	p. 185
Intestinal Failure-Associated Liver Disease	p. 191
Psychiatric Issues in the Assessment of the Patient with Intestinal Failure	p. 201
Munchausen Syndrome by Proxy	p. 206
Pharmacological Approaches to Intestinal Failure
Luminal Nutrient Factors in Intestinal Adaptation and Their Use in Therapy	p. 215
The Role of Humoral Factors in Intestinal Adaptation	p. 223
Autologous Reconstruction of the GI Tract
Autologous Reconstruction of the GI Tract	p. 231
Organ Replacement Therapy for Intestinal Failure
Intestinal Transplantation: Indications and Patient Selection	p. 245
Isolated Small Bowel Transplantation and Combined Liver-Small Bowel Transplantation	p. 254
Living Donor Intestinal Transplantation	p. 262
Isolated Liver Transplantation for Intestinal Failure-Associated Liver Disease	p. 270
Preservation of the Intestine	p. 275
Immediate Postoperative Care of the Intestinal Transplant Recipient	p. 283
Surgical Complications of Intestinal Transplantation	p. 290
Infections in Small Bowel Transplant Recipients	p. 297
Immunosuppression after Intestinal Transplantation	p. 305
Immunology of Intestinal Allograft Rejection	p. 314
Histopathology of Intestinal Transplantation	p. 322
Long-Term Management of Intestinal Transplant Recipients	p. 331
Management of Posttransplant Lymphoproliferative Disease	p. 342
Results of Intestinal Transplantation	p. 349
Psychosocial Assessment and Management of the Transplant Patient/Family in Intestinal Transplantation	p. 357
Financial, Economic and Insurance Issues Pertaining to Intestinal Transplantation: When Is Too Much Not Enough?	p. 363
Index	p. 379
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