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Curr Opin Organ Transplant. 2009 Jun;14(3):256-61. doi: 10.1097/MOT.0b013e32832ac06f.

Some new insights in intestinal failure-associated liver disease.

Author information

1
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Intestinal Failure Rehabilitation Center, Hospital Necker-Enfants Malades, University of Paris-Descartes, 75743 Paris Cedex 15, Paris, France. olivier.goulet@nck.aphp.fr

Abstract

PURPOSE OF REVIEW:

To point new insights in the cholestasis that is a complication of both intestinal failure and parenteral nutrition. View on liver disease has recently evolved with the onset of fish oil-based intravenous lipid emulsions (ILE).

RECENT FINDINGS:

Focused on the role of ILE in causing liver disease. Reversal of cholestasis was recently achieved in infants with short bowel syndrome, by replacing the 'reference' soybean oil-based ILE by fish oil-based ILE.

SUMMARY:

It is likely that this reversal involves several factors such as the change in n-6: n-3 ratio, the reduction in phytosterol load, the increased provision of alpha-tocopherol as antioxidant agent. Alternative issue might be based on the use of a new generation of ILE aiming to provide n-3 and to reduce n-6 fatty acids load while enhancing alpha-tocopherol intake. New data are based on the use of an ILE containing a balanced proportion of four types of oil as a physical mixture of 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil and 15% fish oil with amounts of alpha-tocopherol calculated according to the number of double bonds. This new emulsion was reported to be beneficial in reversing or preventing liver disease.

PMID:
19444108
DOI:
10.1097/MOT.0b013e32832ac06f
[Indexed for MEDLINE]

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