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Intestinal Failure: Diagnosis, Management and Transplantation



Intestinal Failure: Diagnosis, Management and Transplantation

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Intestinal failure is a challenging, emerging field that has been the subject of much research and debate in recent years and has only recently become widely accepted as a distinct clinical syndrome.

This comprehensive book provides an in-depth review of scientific theory and clinical practice relating to intestinal failure with specific emphasis on assessment and management as part of a multidisciplinary team. Compiled by an internationally recognised editorial team, the book provides a practical how-to guide to the management of adult and pediatric patients with intestinal failure, focusing on quality-of-life issues that are at the heart of patient care.

  • World experts from centers of excellence share their clinical experience and expertise, offering the first ever authoritative resource on intestinal failure
  • All aspects of patient management are covered, from diagnosis and medical and surgical management (including transplantation) to nutritional consideration and psychosocial aspects of care
  • Numerous illustrations, flow diagrams and summary boxes complement the text and emphasize important concepts, providing an accessible approach to this complex field

This landmark book is essential reading for any gastroenterologists, surgeons, transplant teams or clinical nutritionists involved in the care of patients with intestinal failure.

List of Contributors.




Part 1 Introduction.

1 The History of Intestinal Failure and Transplantation: Alan N. Langnas (University of Nebraska Medical Center).

Part 2 Intestinal Physiology and Immunology.

2 Intestinal Morphology, Intestinal Regeneration and the Promise of Tissue Engineering: David A.J. Lloyd (St Mark’s Hospital Harrow) and Simon M. Gabe (St Mark’s Hospital Harrow).

3 Basic Physiology of Motility, Absorption and Secretion: Greger Lindberg (Karolinska Institutet).

4 Immunology of the Small Intestine: Liam O’Mahony (University College Cork).

5 Intestinal Adaptation: The Biology of the Intestinal Response to Resection and Disease: Marc S. Levin (St Louis VA Medical Center) and Deborah C. Rubin (Washington University School of Medicine).

Part 3 Intestinal Failure: Definition and Pathophysiology.

6 Intestinal Failure: Definitions and Classifications: Dominique M. Jan (Columbia University).

7 Causes of Intestinal Failure in the Newborn: Yigael Finkel (Karolinska Institutet).

8 Congenital Enteropathies Causing Permanent Intestinal Failure: Olivier Goulet (University of Paris-Descartes).

9 Causes of Intestinal Failure in the Adult: Harry C. Sax (The Warren Alpert Medical School of Brown University).

10 Intestinal Failure Related to Bariatric Surgery: Jon S. Thompson (University of Nebraska Medical Center).

11 Inflammatory Bowel Disease and the Short Bowel Syndrome: Ramsey K. Umar (Feinberg School of Medicine) and Alan L. Buchman (Feinberg School of Medicine).

12 Motility Disorders: Hayat Mousa (Center for Advanced Research in Neuromuscular Gastrointestinal Disorders (C.A.R.I.N.G)) and Carlo Di Lorenzo (The Ohio State University and Columbus Children’s Hospital).

Part 4 Assessment and General Management of Intestinal Failure.

13 Assessment of Intestinal Failure Patients: Clarivet Torres (Georgetown University Hospital).

14 Guidelines for Home Parenteral Nutrition Support in Chronic Intestinal Failure Patients: Bernard Messing (Reference Centre for Rare Digestive Diseases), Francisca Joly (Reference Centre for Rare Digestive Diseases) and Virginie Colomb (Reference Centre for Rare Digestive Diseases).

15 Home Parenteral Nutrition: Complications, Survival, Costs and Quality of Life: John K. DiBaise (Mayo Clinic).

16 Vascular Access, Including Complications: Sanja Kolaček (Children’s Hospital Zagreb) and Julije Meštrović(Spit University Hospital).

17 Enteral Support for Children with Intestinal Failure: Daniel S. Kamin (Children’s Hospital, Boston) and Christopher Duggan (Children’s Hospital, Boston).

18 The Use of Enteral Nutrition in the Adult with Intestinal Failure: Khursheed N. Jeejeebhoy (University of Toronto).

19 The Enteric Flora in Intestinal Failure: Small Intestinal Bacterial Overgrowth and Gut-Derived Sepsis: Eamonn M.M. Quigley (National University of Ireland, Cork), Rodrigo Quera (Hospital Clinico Universidad de Chile) and Ahmed Abu-Shanab (National University of Ireland, Cork).

20 Management of Complex Fluid and Electrolyte Disturbances: Stuart S. Kaufman (Georgetown University Transplant Institute and Children’s National Medical Center) and Erin M. Fennelly (Georgetown University Transplant Institute).

21 Intestinal Failure-Associated Liver Disease: Sue V. Beath (Birmingham Children’s Hospital) and Jeremy M. Woodward (Addenbrooke’s Hospital).

22 Psychiatric Issues in the Assessment of the Patient with Intestinal Failure: James H. Sorrell (Nebraska Medical Center).

23 Munchausen Syndrome by Proxy: Paul E. Hyman (University of Kansas School of Medicine) and Brenda Bursch (David Geffen School of Medicine at UCLA).

Part 5 Pharmacological Approaches to Intestinal Failure.

24 Luminal Nutrient Factors in Intestinal Adaptation and Their Use in Therapy: Jon A. Vanderhoof (Children’s Hospital, Boston) and Rosemary J. Young (Boys Town National Research Hospital).

25 The Role of Humoral Factors in Intestinal Adaptation: Jennifer N. Woodard (University of Illinois at Urbana-Champaign) and Kelly A. Tappenden (University of Illinois at Urbana-Champaign).

Part 6 Autologous Reconstruction of the GI Tract.

26 Autologous Reconstruction of the GI Tract: Debra Sudan (University of Nebraska).

Part 7 Organ Replacement Therapy for Intestinal Failure.

27 Intestinal Transplantation: Indications and Patient Selection: Kareem M. Abu-Elmagd (University of Pittsburgh Medical Center).

28 Isolated Small Bowel Transplantation and Combined Liver-Small Bowel Transplantation: Douglas G. Farmer (Dumont-UCLA Transplant Center).

29 Living Donor Intestinal Transplantation: Enrico Benedetti (University of Illinois at Chicago), Fabrizio Panaro (University of Illinois at Chicago) and Giuliano Testa (University of Chicago Medical Center).

30 Isolated Liver Transplantation for Intestinal Failure-Associated Liver Disease: Jean F. Botha (University of Nebraska Medical Center) and Alan N. Langnas (University of Nebraska Medical Center).

31 Preservation of the Intestine: Vincent B. Nieuwenhuijs (University Medical Center Groningen), Mihai Oltean (Sahlgrenska University Hospital), Henri G. Leuvenink (University of Groningen) and Rutger J. Ploeg (University Medical Center Groningen).

32 Immediate Postoperative Care of the Intestinal Transplant Recipient: Gabriel J. Hauser (Georgetown University Children’s Medical Center), Jeffrey S. Plotkin (Georgetown University Hospital) and Thomas Fishbein (Georgetown University Hospital).

33 Surgical Complications of Intestinal Transplantation: Wendy J. Grant (University of Nebraska Medical Center).

34 Infections in Small Bowel Transplant Recipients: Alison Freifeld (University of Nebraska Medical Center) and Andre Kalil (University of Nebraska Medical Center).

35 Immunosuppression after Intestinal Transplantation: Raquel Garcia-Roca (University of Minnesota) and Rainer Gruessner (University of Arizona).

36 Immunology of Intestinal Allograft Rejection: Kenneth A. Newell (Emory University) and Jonathan P. Fryer (Feinberg School of Medicine).

37 Histopathology of Intestinal Transplantation: Tong Wu (University of Pittsburgh Medical Center) and Anthony J. Demetris (University of Pittsburgh Medical Center).

38 Long-Term Management of Intestinal Transplant Recipients: Frances R. Malone (Children’s Hospital and Regional Medical Center Seattle) and Simon P. Horslen (Children’s Hospital and Regional Medical Center Seattle).

39 Management of Posttransplant Lymphoproliferative Disease: Thomas G. Gross (The Ohio State University).

40 Results of Intestinal Transplantation: David R. Grant (University of Toronto) and Shimul A. Shah (University of Massachusetts Memorial Medical Center).

41 Psychosocial Assessment and Management of the Transplant Patient/Family in Intestinal Transplantation: Jodi Gentleman (The Nebraska Medical Center), Leonard W. Penkoski (University of Nebraska Medical Center).

and James H. Sorrell (Nebraska Medical Center).

42 Financial, Economic and Insurance Issues Pertaining to Intestinal Transplantation: When Is Too Much Not Enough?: Roger W. Evans (Consultant in Health Care Rochester).


“This is a useful, comprehensive, practical guide to modern assessment and management of complex intestinal failure cases. The book was compiled by experienced clinicians resulting in an authoritative, novel resource on intestinal failure.” (Doody's Reviews, March 2009)

“A comprehensive overview of the far-reaching effects of loss of the gut. It is a good update on state-of-the-art treatment of patients … and the authors also go behind the scenes to discuss aspects of care … .Intestinal Failure gives insight into recent progress in the understanding of intestinal failure, covers the most important topics that the clinician working in this area will face … .Despite major improvements in the survival of patients with severe intestinal failure, the treatment of patients with poor gut function remains an exciting and challenging area of medicine, and this book enables the reader to have a good overview and understanding of the topic.” (New England Journal of Medicine, November 2008)

● A practical “how to” manual for the multidisciplinary team managing this difficult patient population
● Considers the diagnosis, treatment (both medical and surgical) and management of adult and pediatric patients with intestinal failure
● Provides a long term view in dealing with these patients to improve results, quality of life and patient care
● Brings together world-leading editorial team to encompass adult and pediatric gastroenterology, surgery and nutrition