Liver Disease in Patients on Total Parenteral Nutrition. 2017

Arnab Mitra, and Joseph Ahn
Department of Medicine, Division of Gastroenterology and Hepatology, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, L461, Portland, OR 97239-3098, USA.

Parenteral nutrition-associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil-based lipid emulsions in TPN formulations to reduce risk and progression of PNALD. With liver and intestinal failure, liver and intestine transplant is an option.

UI MeSH Term Description Entries
D007422 Intestines The section of the alimentary canal from the STOMACH to the ANAL CANAL. It includes the LARGE INTESTINE and SMALL INTESTINE. Intestine
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008107 Liver Diseases Pathological processes of the LIVER. Liver Dysfunction,Disease, Liver,Diseases, Liver,Dysfunction, Liver,Dysfunctions, Liver,Liver Disease,Liver Dysfunctions
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D005217 Fat Emulsions, Intravenous Emulsions of fats or lipids used primarily in parenteral feeding. Intravenous Fat Emulsion,Intravenous Lipid Emulsion,Lipid Emulsions, Intravenous,Emulsion, Intravenous Fat,Emulsion, Intravenous Lipid,Emulsions, Intravenous Fat,Emulsions, Intravenous Lipid,Fat Emulsion, Intravenous,Intravenous Fat Emulsions,Intravenous Lipid Emulsions,Lipid Emulsion, Intravenous
D005234 Fatty Liver Lipid infiltration of the hepatic parenchymal cells resulting in a yellow-colored liver. The abnormal lipid accumulation is usually in the form of TRIGLYCERIDES, either as a single large droplet or multiple small droplets. Fatty liver is caused by an imbalance in the metabolism of FATTY ACIDS. Liver Steatosis,Steatohepatitis,Steatosis of Liver,Visceral Steatosis,Liver Steatoses,Liver, Fatty,Steatohepatitides,Steatoses, Liver,Steatoses, Visceral,Steatosis, Liver,Steatosis, Visceral,Visceral Steatoses
D005395 Fish Oils Oils high in unsaturated fats extracted from the bodies of fish or fish parts, especially the LIVER. Those from the liver are usually high in VITAMIN A. The oils are used as DIETARY SUPPLEMENTS. They are also used in soaps and detergents and as protective coatings. Fish Liver Oils,Fish Oil,Liver Oils, Fish,Oil, Fish,Oils, Fish,Oils, Fish Liver
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016031 Liver Transplantation The transference of a part of or an entire liver from one human or animal to another. Grafting, Liver,Hepatic Transplantation,Liver Transplant,Transplantation, Hepatic,Transplantation, Liver,Hepatic Transplantations,Liver Grafting,Liver Transplantations,Liver Transplants,Transplant, Liver
D048550 Hepatic Insufficiency Conditions in which the LIVER functions fall below the normal ranges. Severe hepatic insufficiency may cause LIVER FAILURE or DEATH. Treatment may include LIVER TRANSPLANTATION. Liver Insufficiency,Insufficiency, Hepatic,Insufficiency, Liver

Related Publications

Arnab Mitra, and Joseph Ahn
January 2002, JPEN. Journal of parenteral and enteral nutrition,
Arnab Mitra, and Joseph Ahn
January 1997, Zhonghua Minguo xiao er ke yi xue hui za zhi [Journal]. Zhonghua Minguo xiao er ke yi xue hui,
Arnab Mitra, and Joseph Ahn
January 1979, Pediatrics,
Arnab Mitra, and Joseph Ahn
October 1988, Journal of hepatology,
Arnab Mitra, and Joseph Ahn
August 1985, The Journal of surgical research,
Arnab Mitra, and Joseph Ahn
January 1981, Acta chirurgica Belgica,
Arnab Mitra, and Joseph Ahn
March 1981, Archives of pathology & laboratory medicine,
Arnab Mitra, and Joseph Ahn
January 1994, Nutrition (Burbank, Los Angeles County, Calif.),
Arnab Mitra, and Joseph Ahn
January 1994, Nutrition (Burbank, Los Angeles County, Calif.),
Arnab Mitra, and Joseph Ahn
November 1984, Annals of surgery,
Copied contents to your clipboard!