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The Authors' response: indications for intestinal transplantation—opinions and facts
  1. Loris Pironi1,
  2. Alastair Forbes2,
  3. André Van Gossum3,
  4. Home Artificial Nutrition & Chronic Intestinal Failure Working Group of the European Society for Clinical Nutrition and Metabolism (ESPEN)
  1. 1Center for Chronic Intestinal Failure, Department of Gastroenterology and Internal Medicine, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
  2. 2Department of Gastroenterology & Nutrition, University College London, University College Hospital, London, UK
  3. 3Department of Gastroenterology, Hopital Erasme, Brussels, Belgium
  1. Correspondence to Loris Pironi, Center for Chronic Intestinal Failure, Department of Gastroenterology and Internal Medicine, St. Orsola-Malpighi Hospital, University of Bologna, Via, Massarenti, 9-40138 Bologna, Italy; loris.pironi{at}unibo.it

http://dx.doi.org/10.1136/gut.2011.241075

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    We thank Abu-Elmagd and Mazariegos1 for their comments and are pleased to have the opportunity to explain our work further.

    Our study2 aimed to determine which indications for intestinal transplantation (ITx) were most closely associated with an increased risk of death on home parenteral nutrition (HPN), and whether deaths were due to causes that could be avoided by ITx. The indications for ITx we considered were those described by Medicare, USA, and the American Society of Transplantation; they include objective parameters which allow clear patient identification. Our results confirm that our baseline patient categorisation was appropriate. Ninety-five per cent of patients who were weaned off HPN belonged to the non-candidate group, and 95% of patients who underwent ITx belonged to the candidate group. Survival on HPN was significantly lower in candidates who had HPN failure. Death on HPN was mainly HPN related in candidates, and related to neither HPN …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; not externally peer reviewed.

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