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  • Original Article
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Prevalence of liver complications in children receiving long-term parenteral nutrition

European Journal of Clinical Nutrition volume 65, pages 743–749 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

The hepatic prognosis of long-term home total parenteral nutrition (TPN)-dependent children is poorly documented. The objective was to study outcome data in home TPN-dependent children and to describe precisely their liver biopsies in the attempt to analyze risk factors for biochemical and histological hepatic abnormalities.

Subjects/Methods:

Medical records of 42 children receiving home TPN for more than 2 years between January 1998 and December 2007 in a single approved home total parenteral center were reviewed. Hepatic biochemical abnormalities were analyzed. Hepatic biopsies were classified by two independent pathologists.

Results:

Duration of TPN was 7.9±0.8 years (mean±s.e.m.), with an average age at onset of 1.5±0.5 years. A total of 24 patients (57%) developed biochemical liver abnormalities in an average of 2.9±0.4 years after starting TPN. Risk factors for biochemical abnormalities were younger age at TPN commencement, longer duration of TPN, higher rate of catheter-related infections and higher volume and energy content of TPN. Liver biopsies were carried out in 43% of patients (mean age 3.2±0.9 years). Almost all patients had fibrosis (94%). Risk factors were dependent on each histological abnormality: fibrosis was significantly associated with a shorter length of bowel and a longer duration of TPN; cholestasis correlated with a lower percentage of total parenteral energy intake due to lipids; and steatosis had no risk factor identified.

Conclusion:

Our study reports a high rate of histological liver abnormalities and analyzes risk factors in children who underwent very long-term home TPN.

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Authors and Affiliations

  1. Pediatric department CHR Annecy, Lyon, France

    B Peyret

  2. Lyon University, INSERM U1060, CarMeN Laboratory, University Lyon-1, Hospices Civils de Lyon, Lyon, France,

    S Collardeau, S Touzet, R Bouvier, A Lachaux & N Peretti

  3. Hospices Civils de Lyon, Lyon, France

    S Collardeau, S Touzet, I Loras-Duclaux, H Yantren, J Chaix, L Restier-Miron, R Bouvier, A Lachaux & N Peretti

  4. Lyon University, INSERM U1060, CarMeN Laboratory, Oullins, France

    M C Michalski & N Peretti

  5. INRA U1235, University Lyon-1, INSA-Lyon, Villeurbanne, France

    M C Michalski

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  1. B Peyret
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Correspondence to N Peretti.

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Peyret, B., Collardeau, S., Touzet, S. et al. Prevalence of liver complications in children receiving long-term parenteral nutrition. Eur J Clin Nutr 65, 743–749 (2011). https://doi.org/10.1038/ejcn.2011.26

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