Parenteral Nutrition Associated Liver Disease: Searching for the Lost Indicator?

ECHEVARRIA CONSTANZA; SOLAR H; CABANNE A; DIAZ C; CRIVELLI A; GONDOLESI G

Simposio; International Small Bowel Transplant Symposium 2015; 2015

Intestinal Transplant Association

Background: Total parenteral nutrition (TPN) therapy is a well-recognizedcause of liver injury, ranging from a persistent elevation ofliver function values, steatosis to advanced fibrosis and cirrhosis.Biochemical changes and histological modifications do not have aclear correlations, therefore, remains unclear when to indicate a liverbiopsy in adult patients with severe intestinal failure (sIF) and TPN.Aim: To describe the correlation between predisposing factors forparenteral nutrition associated liver disease (PNALD), biochemicalalterations, the APRI score and ultrasound findings with the degreeof fibrosis found in liver biopsies (Lbx) of adult patients (pts) with sIF.Materials and Methods: Retrospective analysis of Lbx performedin a group adult pts with sIF, between 02/2006 and 12/2014. Independentvariable: fibrosis grade: METAVIR score (Ms). Dependentvariables: remnant intestinal length, TPN time before Lbx, ultrasoundfindings, increase in liver function tests. (Total bilirubin > 3 times thenormal value; AST, ALT, ALP, GGT:> 1.5 times the upper normalvalue, platelets