Adult patients receiving home parenteral nutrition in Denmark from 1991 to 1996 : Who will benefit from intestinal transplantation ?
Small-bowel transplantation is an alternative to home parenteral nutrition (HPN) in patients with gut failure.
Our aim was to report the indication, diagnosis, morbidity, mortality, and intestinal adaptation in the total cohort of Danish patients receiving HPN at any time during the 5 years between 1 January 1991 and 31 December 1995.
The data were analysed against the option of transplantation.
HPN was given to 129 patients ; 59 (46%) had inflammatory bowel disease (15% died). 26 (20%) had cured cancers (42% died), and 44 (34%) had other diseases (dysmotility, surgical complications, infarcts, and so forth : 27% died).
Of these, 60% were new in the HPN program, but only 19% received HPN all 5 years : 31% had terminated HPN, 19% permanently, and 25% died.
Only four deaths were HPN-related.
In December 1995. 73 patients were receiving HPN in Denmark, for a prevalence of 13.9 per million, which is the highest in Europe but 10-fold lower than in the United States.
Gut failure was the only indication for HPN in Denmark.
Weight loss without gut failure, such as disseminated cancer and acquired immunodeficiency syndrome. was not an indication for HPN.
Survival after small-bowel transplantation should be assessed against a sizeable mortality among candidates receiving HPN. and this depends on diagnosis and age.
In an HPN population comparable with the Danish, a quarter is likely to die within a period of 5 years, a quarter will terminate HPN. (...)
Mots-clés Pascal : Nutrition, Voie parentérale, A domicile, Intestin, Trouble fonctionnel, Etude cohorte, Morbidité, Mortalité, Indication, Homotransplantation, Diagnostic, Evaluation, Danemark, Europe, Homme, Métabolisme pathologie, Appareil digestif pathologie, Intestin pathologie, Transplantation, Chirurgie
Mots-clés Pascal anglais : Nutrition, Parenteral administration, At home, Gut, Dysfunction, Cohort study, Morbidity, Mortality, Indication, Homotransplantation, Diagnosis, Evaluation, Denmark, Europe, Human, Metabolic diseases, Digestive diseases, Intestinal disease, Transplantation, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0446126
Code Inist : 002B26F. Création : 25/01/1999.