The Importance of Nutrition Management in Intestinal Transplantation

Background: Our institution utilizes a multidisciplinary team approach to wean parenteral support (PS) after intestinal transplant (ITx).Our aim was to evaluate whether pre-transplant clinical features impact restoration of nutrition autonomy and the need for ongoing nutrition modifications post-transplant.Methods: In this retrospective chart review, we included 116 adult ITx recipients from 2013-2024.Patients lost to follow-up within 1-year were excluded.We collected patient demographics, etiology of intestinal failure, transplant type, nutrition status and PS use before transplant and at follow-up by the registered dietitians (RD).Results: Among 116 patients (age 20-76 years, 60% female) 80 (69%) received ITx only and the rest received multi-organs.(Table 1).Although all (100%) were PS dependent, 31 (27%) were malnourished pretransplant.Nineteen (16%) patients died within 1 year, of which 6/19 (32%) were malnourished at base line.Of the 97 survivors, 58 (60%) achieved enteral autonomy 1year post-transplant; 43 of these 58 (74%) were well-nourished.Diets included unrestricted diet (41%), low sugar (30%) and low fiber diet (20%).Nutritional autonomy was similarly achieved in ITx and multi-organ transplants (60% vs. 58%, p=1.00), but significantly more likely in patients with vascular-origin etiology (82%, p=0.006) and less likely in those with neoplasm (31%, p=0.032).Conclusions: ITx can achieve nutritional autonomy with varied likelihood based on primary disease.Even patients who discontinue PS require continued attention for nutritional optimization and dietary adjustments, underscoring the importance of a multidisciplinary ITx care model involving nutrition specialists.