Nutrition and small bowel transplantation.

Intestinal transplantation is indicated for patients with intractable intestinal failure, especially when life-threatening complications of parenteral nutrition (PN) occur. The rates of 1- and 5-year graft survival range from 65%–80% and 40%–50% across differing age ranges, with adult recipients generally performing better. Despite nutrition being so central to intestinal transplantation, there are little published literature and essentially no data from clinical trials. In this review, we critically examine published manuscripts in an attempt to draw common themes between various transplant programs, covering experimental physiologic data, published nutrition protocols, and common postoperative management issues. We conclude that the well-established intestinal graft in a healthy state absorbs key nutrients adequately to wean off PN and that the wide variation in practice across different programs suggests that different approaches can equally lead to success.