Gastroenterology Clinics of North America 
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Outcomes for patients with chronic intestinal failure have improved with organization of experts into multidisciplinary teams delivering care in intestinal rehabilitation programs. There have been improvements in understanding of intestinal failure complications as well as development of newer therapies that have amplified the improvements in survival. In spite of this encouraging trend, patients who fail PN are often referred too late for intestinal transplantation. The author proposes a more rational framework that might allow earlier identification of intestinal failure patients at risk for PN-failure, who could appropr...
Source: Gastroenterology Clinics of North America - April 2, 2024 Category: Gastroenterology Authors: Kishore R. Iyer Source Type: research
Not Even a Ribbon for Intestinal Failure
Possibly the most complex and heterogenous disease known to mankind, intestinal failure, had neither recognition nor a colored ribbon. There was no disease code in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10CM) or ICD-11 for either intestinal failure or short bowel syndrome until October 1, 2023; still, there is no ribbon. All the primary color ribbons have been taken —even burgundy, cranberry, peach, and pink; light blue, dark blue, navy blue, and even Robin’s egg blue; jade, light green, lime green, and mint green; cream, copper, and brown—yes brown: it’s antitobacc...
Source: Gastroenterology Clinics of North America - March 23, 2024 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research
Normothermic Preservation of the Intestinal Allograft
Intestinal allotransplantation was first described in the 1960s and successfully performed in the 1980s. Since that time, less progress has been made in the preservation of the allograft before transplantation and static cold storage remains the current standard. Normothermic machine perfusion represents an opportunity to simultaneously preserve, assess, and recondition the organ for transplantation and improve the procurement radius for allografts. The substantial progress made in the field during the last 60 years, coupled with the success of the preclinical animal model of machine perfusion-preserved intestinal transp...
Source: Gastroenterology Clinics of North America - March 21, 2024 Category: Gastroenterology Authors: Joseph M. Ladowski, Debra L. Sudan Source Type: research
Intestinal Transplantation
The traditional procedure for multivisceral transplant (MVT) is to transplant the stomach, pancreas, intestine, and liver en bloc. During surgery, the native spleen is routinely removed from the recipient, and it usually creates more space in the abdomen to insert the allogeneic graft. Thus, recipients often become asplenic after MVT. Considering all of the risks and benefits, we advocate that temporary transplant of the donor spleen could be the best option for MVT recipients; it could potentially reduce the rate of intestinal allograft rejection without increasing the risk for graft-versus-host disease. (Source: Gastroen...
Source: Gastroenterology Clinics of North America - March 18, 2024 Category: Gastroenterology Authors: Rei Matsumoto, Tomoaki Kato Source Type: research
Innate and Adaptive Immune Responses in Intestinal Transplant Rejection
Intestinal transplantation is a life-saving procedure utilized for patients failing total parenteral nutrition. However, intestinal transplantattion remains plagued with low survival rates and high risk of allograft rejection. The authors explore roles of innate (macrophages, natural killer cells, innate lymphoid cells) and adaptive immune cells (Th1, Th2, Th17, Tregs) in inflammatory responses, particularly inflammatory bowel disease and graft versus host disease, and correlate these findings to intestinal allograft rejection, highlighting which effectors exacerbate or suppress intestinal rejection. Better understanding o...
Source: Gastroenterology Clinics of North America - February 15, 2024 Category: Gastroenterology Authors: Yuki Cui, Ryan G. Hackett, Jhalen Ascue, Vinona Muralidaran, Digvijay Patil, Jiman Kang, Stuart S. Kaufman, Khalid Khan, Alexander Kroemer Source Type: research
Intestinal Re-Transplantation
The history of intestinal transplantation can be traced back to the turn of the twentieth century. Although advancements have been made, the intestine still presents a greater challenge to transplantation than does that of other solid organs, experiencing higher rates of graft rejection and lower long-term survival. Increasingly, intestinal re-transplantation (re-ITx) is seen as a viable option and is now the fourth most common indication for ITx. Changes to immunosuppression protocols, technical modifications, and infectious disease monitoring have contributed to improved outcomes. The authors review the literature on re-...
Source: Gastroenterology Clinics of North America - February 13, 2024 Category: Gastroenterology Authors: Carolyn P. Smullin, Robert S. Venick, Elizabeth A. Marcus, Suzanne V. McDiarmid, Hasan Yersiz, Ronald W. Busuttil, Douglas G. Farmer Source Type: research
A Novel Organoid-Based Strategy Using Hybrid Colon Interposition for Short Bowel Syndrome
This study not only underscores the importance of integrating organoid technology and surgical techniques to improve the outcomes of patients with SBS but also acknowledges the challenges that lie ahead, including achieving functional organoids with peristaltic movement and vascu larization. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 13, 2024 Category: Gastroenterology Authors: Motoshi Wada, Kazuhiro Watanabe, Shinya Sugimoto, Toshiro Sato, Eiji Kobayashi Source Type: research
Metabolic Regulation of Microbiota and Tissue Response
The microbiota in our gut regulates the sophisticated metabolic system that the human body has, essentially converting food into energy and the building blocks for various bodily functions. In this review, we discuss the multifaceted impact of the microbiota on host nutritional status by producing short-chain fatty acids, influencing gut hormones and mediating bile acid metabolism, and the key role in maintaining intestinal barrier integrity and immune homeostasis. Understanding and leveraging the power of the gut microbiome holds tremendous potential for enhancing human health and preventing various diseases. (Source: Gas...
Source: Gastroenterology Clinics of North America - February 12, 2024 Category: Gastroenterology Authors: Zhilu Xu, Manman Chen, Siew Chien Ng Source Type: research
Strategies to Promote Success in Oral Feedings in Infants and Children with Intestinal Failure due to Short Bowel Syndrome
This article explores these challenges and offers several practical strategies that can be used by multidisciplinary care teams and at-home caregivers to help support the development of oral feeding in these children and eventually lead to their attaining enteral autonomy. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 12, 2024 Category: Gastroenterology Authors: Judy Hopkins, Russell Merritt Source Type: research
Indications for Multivisceral Transplantation
Consensus remains elusive in the definition and indications of multivisceral transplantation (MVT) within the transplant community. MVT encompasses transplantation of all organs reliant on the celiac artery axis and the superior mesenteric artery in different combinations. Some institutions classify MVT as involving the grafting of the stomach or ascending colon in addition to the jejunoileal complex. MVT indications span a wide spectrum of conditions, including tumors, intestinal dysmotility disorders, and trauma. This systematic review aims to consolidate existing literature on MVT cases and their indications, providing ...
Source: Gastroenterology Clinics of North America - February 8, 2024 Category: Gastroenterology Authors: Pierpaolo Di Cocco, Alessandro Martinino, Amy Lian, Jess Johnson, Mario Spaggiari, Ivo Tzvetanov, Enrico Benedetti Source Type: research
Pediatric Intestinal Failure Associated Eating Disorder
Achieving feeding skills and food acceptance is a multi-layered process. In pediatric intestinal failure (PIF), oral feeding is important for feeding skills development, physiologic adaptation, quality of life and the prevention of eating disorders. In PIF, risk factors for feeding difficulties are common and early data suggests that feeding difficulties are prevalent. There is a unique paradigm for the feeding challenges in PIF. Conventional definitions of eating disorders have limited application in this context. A pediatric intestinal failure associated eating disorder (IFAED) definition that includes feeding/eating ski...
Source: Gastroenterology Clinics of North America - January 31, 2024 Category: Gastroenterology Authors: Dana Liza Boctor, Tanis R. Fenton, Olivier Goulet, Cecile Lambe Source Type: research
Pathology and Clinical Relevance of Gastric Epithelial Dysplasia
Gastric dysplasia is defined as an unequivocally neoplastic epithelium. Dysplastic lesions are characterized by cellular atypia reflective of abnormal differentiation and disorganized glandular architecture. The last few years have been marked by a refinement of the prognosis and risk of progression of gastric dysplasia and the recognition of novel morphologic patterns of dysplasia. Determination of the correct diagnosis and grade of dysplasia are critical steps since it will be predicting the risk of malignant transformation and help tailor appropriate surveillance strategy. This review describes the morphologic character...
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Authors: Tetsuo Ushiku, Gregory Y. Lauwers Source Type: research
Gastrointestinal Tract, Liver, and Pancreatic/Biliary Precursor Lesions
This issue of Gastroenterology Clinics of North America represents a contemporary clinical and pathology update of neoplastic precursors of the GI, liver, and pancreatic/biliary tract that was originally published in Gastroenterology Clinics of North America in 2007. Since the time of that publication, there have been many key developments in our understanding of the clinical and biological characteristics, pathogenesis, molecular features, and pathology of gastrointestinal (GI), liver, and pancreatic/biliary precursor lesions. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Authors: Robert D. Odze Tags: Preface Source Type: research
Pathology And Clinical Relevance Of Neoplastic Precursor Lesions Of The Tubal Gut, Liver, And Pancreaticobiliary System: A Contemporary Update
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Authors: ROBERT D. ODZE Source Type: research
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Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Source Type: research
