Intestine transplant is indicated for patients with intestinal failure who are unable to be weaned from parenteral nutrition (PN). Long-term PN, although life sustaining in many patients, can be associated with life-threatening complications including PN-associated liver disease (PNALD). Most patients are not considered for intestine transplant until they have developed severe PNALD and also need a liver transplant. Overall outcomes with intestinal transplantation are steadily improving, and current 1-year patient survivals for intestine-only transplants are now similar to those for liver transplant. Intestinal transplantation should be considered earlier in intestinal failure patients who are at high risk for developing PNALD and other life-threatening complications.
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