PROGNOSIS OF PATIENTS WITH NONMALIGNANT CHRONIC INTESTINAL FAILURE RECEIVING LONG-TERM HOME PARENTERAL-NUTRITION

Background/Aims: Long-term Survival of patients with intestinal failur e requiring home parenteral nutrition (HPN) has been only partly shown . Therefore, we described the survival of these patients and explored prognosis factors. Methods: Two hundred seventeen noncancer non-acquir ed immunodeficiency syndrome adult patients presenting with chronic in testinal failure enrolled from January 1980 to December 1989 in approv ed HPN programs in Belgium and France; prognosis factors of survival w ere explored using multivariate analysis. Data were updated in March 1 991; not one of the patients was lost to followup. Results: Seventy-th ree patients died during the survey, and the mortality rate related to HPN complications accounted for 11% of deaths. Probabilities of survi val at 1, 3, and 5 years were 91%, 70%, and 62%, respectively. Three i ndependent variables were associated with a de creased risk of death: age of patients younger than 40 years, start of HPN after 1987, and ab sence of chronic intestinal obstruction. In patients younger than 60 y eats of age included after 1983 with a very short bowel, who could rep resent suitable candidates for small bowel transplantation, the 2-year survival rate was 90%, a prognosis that compared favorably with recen t reports of survival after small bowel transplantation. Conclusions: HPN prognosis compares favorably with recent reports of survival after small bowel transplantation.