Twenty two children were evaluated for small bowel transplantation bet
ween 1989 and 1994. Eight were unfit for transplantation and died with
in three months; a raised plasma bilirubin concentration (>200 mu mol/
l) predicted death from liver failure within six months (p=0.0001). Th
e 11 children who were not managed by a multidisciplinary nutritional
care team were less well nourished at referral, had more complications
with intravenous feeding catheters, and greater early mortality while
awaiting transplantation (p<0.05). It is recommended that children wi
th chronic intestinal failure be referred for assessment early, before
liver dysfunction is established.