Liver Disease in Patients on Total Parenteral Nutrition

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38 Scopus citations


Parenteral nutrition-associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil–based lipid emulsions in TPN formulations to reduce risk and progression of PNALD. With liver and intestinal failure, liver and intestine transplant is an option.

Original languageEnglish (US)
Pages (from-to)687-695
Number of pages9
JournalClinics in liver disease
Issue number4
StatePublished - Nov 2017


  • Cholestasis of sepsis
  • Combined intestinal and liver failure
  • TPN

ASJC Scopus subject areas

  • Hepatology


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