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Background: Total parenteral nutrition (TPN) is known to be life-saving in patients with intestinal failure. But long-term TPN-related complications especially liver dysfunction have been the focus of studies. In this article, we address the evidence of TPN-induced liver lesions and the pathogenesis of these lesions.
Data sources: The articles about the relationship between TPN and liver function were retrieved from PubMed database.
Results: Varied injuries to the liver are induced clinically and experimentally by progressive deterioration after a longer period of TPN infusion. The mechanisms of cholestasis and fibrosis in pathological changes include alteration of trace elements in hepatocytes, metabolic disturbance of fatty acid, calorie overload, lithocholate effect, sepsis, etc. The administration route of TPN is excluded from the pathogenesis of liver disease, and light infusion should be avoided.
Conclusions: TPN may lead to liver dysfunction, but the causes are multifactorial. The authentic factor is unknown although progresses have been made in this field. Since conspicuous lesions are confined in the mesenchyma, further studies should concentrate on the relationship between Ito cells and TPN administration. The significant step toward the gene expression profiling of TPN-supplied liver is to elucidate the real etiologies.Key words: total parenteral nutrition; liver dysfunction; pathogenesis
World J Pediatr 2007;3(2):104-109
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