Indications for referral of adults to an intestinal transplantation centre
| (1) Complications of parenteral nutrition: |
| • Substantial venous occlusion with residual availability of: |
| ‐ 2 or less major neck venous access sites with loss of one or more femoral sites or |
| ‐ 1 or less major neck venous access site with both femoral sites available. |
| • Line related infection (events occurring despite review at an intestinal failure centre): |
| ‐ recurrent episodes of severe line related sepsis requiring more than two line replacements in a year or |
| ‐ recurrent fungal line related infections |
| • Parenteral nutrition related liver disease |
| ‐ Impending or overt liver failure as indicated by portal hypertension, hepatic cirrhosis, or bridging fibrosis |
| (2) Requirement for extensive evisceration |
| • Desmoid tumours |
| ‐ (malignant disease in very select circumstances, usually neuroendocrine or cholangiocarcinoma) (modified from Buchman and colleagues27) |