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Intestinal failure and small intestine transplantation

Publication at Faculty of Medicine in Pilsen, First Faculty of Medicine, Second Faculty of Medicine, Faculty of Medicine in Hradec Králové |
2017

Abstract

Even though medicine can, using laboratory and imaging methods, define the failure of many organs accurately and well, the issue of intestinal failure - its definition, diagnostics and complex treatment - has been escaping focus for years. The monograph "Intestinal failure and small intestine transplantation" is the first comprehensive work available on the Czech market, aiming to cover this issue in a complex manner.

The introductory chapters of the book are devoted to the physiology, pathophysiology and immunology of the intestine, the largest part of the human immune system, including its basic functions, further chapters are focused diagnosing intestine failure and the available treatment options. Due to the severity of the condition in which patients with intestinal failure find themselves, we must not forget about their psychological condition either - in addition to treating their body, their mind needs care as well.

Special focus is devoted to intestinal failure in children, which has both different aetiology and different course and possibilities of adaptation, compared to adult population. Failure of the small intestine is a life-threatening condition, which is currently in most cases manageable, thanks to complex care.

Shortly after the condition develops, the roles of intensive care specialist, intervention radiologists and surgeons is decisive, regarding saving the patient's life. The advances in the field of metabolic research and nutrition led to most patients leaving hospital soon for outpatient care.

They often become long-term patients, dependent on parenteral nutrition. Their quality of life is influenced by many factors and comorbidities associated with their condition.

Many of them require repeated interventions, with complex surgeries. Correct timing of these interventions and carrying them out precisely and meticulously are important influences on the process of intestinal adaptation and achieving partial or complete nutritional independence.

Even despite all these advances, some patients develop severe complications, which make it impossible to continue administering normal nutrition. For these patients and for patients with some complex diseases of the abdominal cavity, transplantation is the only alternative for survival, often with very good quality of life afterwards.

Results of this form of treatment are getting steadily better, which can be seen in the data from international registries. This book is a cross-section of many specialisations which deal with intestinal failure, not just clinical physicians but also other complimentary specialists, whose findings often form the basis of subsequent clinical procedures.

The goal of this monograph is to provide a comprehensive view of this multidisciplinary approach requiring condition to its readers.