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Clinical approach to the management of Intestinal Failure Associated Liver Disease (IFALD) in adults: A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

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Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN). / Clinical approach to the management of Intestinal Failure Associated Liver Disease (IFALD) in adults : A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN. I: Clinical nutrition (Edinburgh, Scotland). 2018 ; Bind 37, Nr. 6 Pt A. s. 1794-1797.

Bibtex

@article{d56751a5240d43de8c7614439932f8dd,
title = "Clinical approach to the management of Intestinal Failure Associated Liver Disease (IFALD) in adults: A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN",
abstract = "We recommend that intestinal failure associated liver disease (IFALD) should be diagnosed by the presence of abnormal liver function tests and/or evidence of radiological and/or histological liver abnormalities occurring in an individual with IF, in the absence of another primary parenchymal liver pathology (e.g. viral or autoimmune hepatitis), other hepatotoxic factors (e.g. alcohol/medication) or biliary obstruction. The presence or absence of sepsis should be noted, along with the duration of PN administration. Abnormal liver histology is not mandatory for a diagnosis of IFALD and the decision to perform a liver biopsy should be made on a case-by-case basis, but should be particularly considered in those with a persistent abnormal conjugated bilirubin in the absence of intra or extra-hepatic cholestasis on radiological imaging and/or persistent or worsening hyperbilirubinaemia despite resolution of any underlying sepsis and/or any clinical or radiological features of chronic liver disease. Nutritional approaches aimed at minimising PN overfeeding and optimising oral/enteral nutrition should be instituted to prevent and/or manage IFALD. We further recommend that the lipid administered is limited to less than 1 g/kg/day, and the prescribed omega-6/omega-3 PUFA ratio is reduced wherever possible. For patients with any evidence of progressive hepatic fibrosis or overt liver failure, combined intestinal and liver transplantation should be considered.",
author = "Simon Lal and Loris Pironi and Geert Wanten and Jann Arends and Federico Bozzetti and Cristina Cuerda and Francisca Joly and Darlene Kelly and Michael Staun and Kinga Szczepanek and {Van Gossum}, Andre and Schneider, {Stephane Michel} and {Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN)}",
note = "Copyright {\circledC} 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.",
year = "2018",
month = "12",
doi = "10.1016/j.clnu.2018.07.006",
language = "English",
volume = "37",
pages = "1794--1797",
journal = "Clinical Nutrition, Supplement",
issn = "0261-5614",
publisher = "Elsevier BV",
number = "6 Pt A",

}

RIS

TY - JOUR

T1 - Clinical approach to the management of Intestinal Failure Associated Liver Disease (IFALD) in adults

T2 - A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

AU - Lal, Simon

AU - Pironi, Loris

AU - Wanten, Geert

AU - Arends, Jann

AU - Bozzetti, Federico

AU - Cuerda, Cristina

AU - Joly, Francisca

AU - Kelly, Darlene

AU - Staun, Michael

AU - Szczepanek, Kinga

AU - Van Gossum, Andre

AU - Schneider, Stephane Michel

AU - Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN)

N1 - Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

PY - 2018/12

Y1 - 2018/12

N2 - We recommend that intestinal failure associated liver disease (IFALD) should be diagnosed by the presence of abnormal liver function tests and/or evidence of radiological and/or histological liver abnormalities occurring in an individual with IF, in the absence of another primary parenchymal liver pathology (e.g. viral or autoimmune hepatitis), other hepatotoxic factors (e.g. alcohol/medication) or biliary obstruction. The presence or absence of sepsis should be noted, along with the duration of PN administration. Abnormal liver histology is not mandatory for a diagnosis of IFALD and the decision to perform a liver biopsy should be made on a case-by-case basis, but should be particularly considered in those with a persistent abnormal conjugated bilirubin in the absence of intra or extra-hepatic cholestasis on radiological imaging and/or persistent or worsening hyperbilirubinaemia despite resolution of any underlying sepsis and/or any clinical or radiological features of chronic liver disease. Nutritional approaches aimed at minimising PN overfeeding and optimising oral/enteral nutrition should be instituted to prevent and/or manage IFALD. We further recommend that the lipid administered is limited to less than 1 g/kg/day, and the prescribed omega-6/omega-3 PUFA ratio is reduced wherever possible. For patients with any evidence of progressive hepatic fibrosis or overt liver failure, combined intestinal and liver transplantation should be considered.

AB - We recommend that intestinal failure associated liver disease (IFALD) should be diagnosed by the presence of abnormal liver function tests and/or evidence of radiological and/or histological liver abnormalities occurring in an individual with IF, in the absence of another primary parenchymal liver pathology (e.g. viral or autoimmune hepatitis), other hepatotoxic factors (e.g. alcohol/medication) or biliary obstruction. The presence or absence of sepsis should be noted, along with the duration of PN administration. Abnormal liver histology is not mandatory for a diagnosis of IFALD and the decision to perform a liver biopsy should be made on a case-by-case basis, but should be particularly considered in those with a persistent abnormal conjugated bilirubin in the absence of intra or extra-hepatic cholestasis on radiological imaging and/or persistent or worsening hyperbilirubinaemia despite resolution of any underlying sepsis and/or any clinical or radiological features of chronic liver disease. Nutritional approaches aimed at minimising PN overfeeding and optimising oral/enteral nutrition should be instituted to prevent and/or manage IFALD. We further recommend that the lipid administered is limited to less than 1 g/kg/day, and the prescribed omega-6/omega-3 PUFA ratio is reduced wherever possible. For patients with any evidence of progressive hepatic fibrosis or overt liver failure, combined intestinal and liver transplantation should be considered.

U2 - 10.1016/j.clnu.2018.07.006

DO - 10.1016/j.clnu.2018.07.006

M3 - Journal article

VL - 37

SP - 1794

EP - 1797

JO - Clinical Nutrition, Supplement

JF - Clinical Nutrition, Supplement

SN - 0261-5614

IS - 6 Pt A

ER -

ID: 56503744