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Hepatic explant pathology of pediatric intestinal transplant recipients previously treated with omega-3 fatty acid lipid emulsion.

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Citation: Journal of Pediatrics. 165(1):59-64, 2014 Jul.PMID: 24793206Institution: MedStar Washington Hospital CenterDepartment: Surgery/TransplantationForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Fat Emulsions, Intravenous | *Fish Oils/ad [Administration & Dosage] | *Hyperbilirubinemia/th [Therapy] | *Intestinal Diseases/th [Therapy] | *Intestines/tr [Transplantation] | *Liver Cirrhosis/di [Diagnosis] | *Liver/pa [Pathology] | Bilirubin/bl [Blood] | Child, Preschool | Fatty Acids, Omega-6/ad [Administration & Dosage] | Fatty Acids, Omega-6/tu [Therapeutic Use] | Female | Fish Oils/tu [Therapeutic Use] | Humans | Intestinal Diseases/co [Complications] | Intestinal Diseases/su [Surgery] | Liver Function Tests | Liver Transplantation | Male | Treatment OutcomeLocal holdings: Available online from MWHC library: 1995 - presentISSN:

0022-3476

Name of journal: The Journal of pediatricsAbstract: CONCLUSIONS: In a matched comparison of patients undergoing intestinal transplantation with a history of extended O3FA lipid emulsion therapy that successfully reversed hyperbilirubinemia, significant hepatic fibrosis was present in the explanted livers despite a reduction in inflammation. This result confirms concern that the use of O3FA may have a limited role in altering the development of hepatic fibrosis from parenteral nutrition. Copyright 2014 Elsevier Inc. All rights reserved.OBJECTIVE: To evaluate and compare the biochemical and histologic effect of parenteral fish oil lipid emulsion that is rich in omega-3 polyunsaturated fatty acids (O3FAs), Omegaven (Fresenius Kabi AG, Bad Homburg, Germany) with standard omega-6 polyunsaturated fatty acid (O6FA) parenteral nutrition.RESULTS: Seven liver-inclusive intestinal transplants were performed in 7 patients who received O3FA for a mean of 62% + 13% of total patient life-span (16.1 + 7.0 months) before transplant. Median total bilirubin fell from 6.9 mg/dL at the start of treatment to 0.7 mg/dL at the time transplant (P < .02), which was a significant decrease compared with the similarly matched O6FA cohort (P = .012). All 7 of the 03FA-treated patients received a liver-inclusive intestinal transplant had advanced fibrosis (stage 3 or 4) noted on explant pathologic examination, despite a resolution of cholestasis at the time of transplant. Histologic inflammatory scores were lower (P = .056) in the 03FA group with similar degrees of advanced fibrosis as in the O6FA group.STUDY DESIGN: Comparison of hepatic explant pathology and biochemical outcome on pediatric patients with intestinal failure treated with either parental O3FA or O6FA who had received a liver-inclusive intestine transplant.All authors: Fishbein TM, Island ER, Kallakury B, Kaufman SS, Khan KM, Matsumoto CS, Yazigi NADigital Object Identifier:

http://dx.doi.org/10.1016/j.jpeds.2014.03.034

Date added to catalog: 2014-09-23

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available		24793206

Available online from MWHC library: 1995 - present

CONCLUSIONS: In a matched comparison of patients undergoing intestinal transplantation with a history of extended O3FA lipid emulsion therapy that successfully reversed hyperbilirubinemia, significant hepatic fibrosis was present in the explanted livers despite a reduction in inflammation. This result confirms concern that the use of O3FA may have a limited role in altering the development of hepatic fibrosis from parenteral nutrition. Copyright 2014 Elsevier Inc. All rights reserved.

OBJECTIVE: To evaluate and compare the biochemical and histologic effect of parenteral fish oil lipid emulsion that is rich in omega-3 polyunsaturated fatty acids (O3FAs), Omegaven (Fresenius Kabi AG, Bad Homburg, Germany) with standard omega-6 polyunsaturated fatty acid (O6FA) parenteral nutrition.

RESULTS: Seven liver-inclusive intestinal transplants were performed in 7 patients who received O3FA for a mean of 62% + 13% of total patient life-span (16.1 + 7.0 months) before transplant. Median total bilirubin fell from 6.9 mg/dL at the start of treatment to 0.7 mg/dL at the time transplant (P < .02), which was a significant decrease compared with the similarly matched O6FA cohort (P = .012). All 7 of the 03FA-treated patients received a liver-inclusive intestinal transplant had advanced fibrosis (stage 3 or 4) noted on explant pathologic examination, despite a resolution of cholestasis at the time of transplant. Histologic inflammatory scores were lower (P = .056) in the 03FA group with similar degrees of advanced fibrosis as in the O6FA group.

STUDY DESIGN: Comparison of hepatic explant pathology and biochemical outcome on pediatric patients with intestinal failure treated with either parental O3FA or O6FA who had received a liver-inclusive intestine transplant.

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