Patients selection: long-term total parenteral nutrition for significant bowel disease
Conditions which may justify small intestinal transplantation:
(1) impending or overt liver failure secondary to TPN
(1a) cholestatic syndrome
(1b) cirrhosis or severe hepatic fibrosis
(1c) complication of cirrhosis (thrombocytopenia, bleeding varices, splenomegaly)
(2) >= 2 thrombosis in major veins used for vascular access
(3) serious infections associated with central vascular access
(3a) >= 2 episodes per year of sepsis associated with central line infections
(3b) >=1 episode of line-associated fungemia
(3c) >= 1 episode of septic shock and/or ARDS
(4) frequent episodes of severe dehydration despite intravenous fluid administration
where:
• The presence of frequent thromboses may indicated a hypercoagulable state.
