Unidad de Insuficiencia, Soporte Nutricional, Rehabilitación y Trasplante Intestinal. Hospital Universitario-Fundación Favaloro, Buenos Aires, Argentina.
Intestinal Transplant Unit, Shiraz Medical Center, Shiraz, Iran.
Curr Opin Organ Transplant. 2018 Apr;23(2):212-218. doi: 10.1097/MOT.0000000000000512.
Intestinal failure is a life-threatening medical condition that remains as a rare or orphan disease in most countries. The prevalence of intestinal failure and the therapeutic options available in middle-income countries (MIC) remain unclear. We aim to provide an overview on the current differences in management of intestinal failure patients in MIC from Latin America and Asia.
In order to fulfil the challenge, and after facing the difficulties of going over a topic with scarce available data, from countries with an extreme variety of social and economic problems, which are closely related to the treatment of intestinal failure patients, we have used both the existing publications and personal surveys to draft this document. Our results have shown that there is still significant disparity among MIC over the last years, concepts such as the need for establishing multidisciplinary dedicated teams as well as the need to evolve first home parenteral nutrition (HPN), then rehabilitation, and finally transplantation, have become important signals of an adequate understanding of this evolving field.
The manuscript presents, for the first time, an overview of the different developments and needs to manage intestinal failure patients in MIC from Latin America and Asia. Future discussions will emerge from this manuscript, aiming to pursue the development of registries, guidelines and health policies to continue improving the long-term care of intestinal failure patients in all MIC.
目的综述:肠衰竭是一种危及生命的疾病,在大多数国家仍然是一种罕见病或孤儿病。肠衰竭的患病率以及中等收入国家(MIC)的可用治疗选择尚不清楚。我们旨在概述拉丁美洲和亚洲 MIC 中肠衰竭患者管理方面的当前差异。
最新发现:为了应对这一挑战,我们克服了在处理一个数据稀缺、社会和经济问题极端多样化且与肠衰竭患者治疗密切相关的主题时所面临的困难,使用了现有出版物和个人调查来起草这份文件。我们的研究结果表明,近年来 MIC 之间仍存在显著差异,例如需要建立多学科专用团队,以及需要先进行家庭肠外营养(HPN),然后进行康复,最后进行移植等概念,这些概念已经成为对这一不断发展的领域的充分理解的重要标志。
总结:本文首次概述了拉丁美洲和亚洲 MIC 中肠衰竭患者管理方面的不同发展和需求。未来的讨论将从本文中出现,旨在继续推进登记册、指南和卫生政策的制定,以持续改善所有 MIC 中肠衰竭患者的长期护理。