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P0605 - Effects of Probiotics on Intestinal Failure-Associated Liver Disease in Adult Patients Receiving Prolonged Parenteral Support: A Tertiary Care Center Experience

Sunday, October 27

3:30 PM - 7:00 PM

Location: Exhibit Halls 3 and 4 (Street Level)

Presenting Author(s)

Mohammad Alomari, MD

Resident
Cleveland Clinic Foundation
Cleveland, Ohio

Mohammad Alomari, MD¹, Laith Al Momani, MD², Muhammad Talal Sarmini, MD¹, Bara El Kurdi, MD², Shrouq Khazaaleh, MD³, Fredy Nehme, MD⁴, Mark Young, MD², Carlos Romero-Marrero, MD, MSc⁵

¹Cleveland Clinic Foundation, Cleveland, OH; ²East Tennessee State University, Johnson City, TN; ³King Abdullah University Hospital, Ar Ramtha, Irbid, Jordan; ⁴University of Missouri, Kansas City, MO; ⁵Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH

Introduction: It has been hypothesized that dysbiosis plays a significant role in the pathogenesis of intestinal failure-associated liver disease (IFALD). Therefore, we aimed to investigate the effect of probiotics on IFALD in patients receiving prolonged parenteral support, namely home parenteral nutrition (HPN) and intravenous fluids (HIVF).

Methods: We identified a cohort of patients with intestinal failure (IF) who received HPN or HIVF for >2 weeks at our tertiary center between January 2005 and August 2016. (Table 1) We excluded patients < 18 years of age, patients with other causes of liver disease, patients who used probiotics for < 30 days, patients with < 6 months follow up and those who had long-term antibiotic use ( >30 days). Bivariable and multivariable logistic regression analyses were used in this study.

Results: A total of 282 patients who received prolonged parenteral support were included. Eighty-five percent of our sample received PN, while the remaining got HIVF. A total of 78 (27.7%) patients used probiotics. The prevalence of IFALD in patients who used probiotic was 35.9% vs. 54.4% in patients who did not use probiotics, p = 0.005. In multivariable analysis, only small bowel length of 10-90 cm and HPN use showed a significant impact on IFALD, OR= 4.114 (95% CI=1.557-10.874, P=0.004), OR = 4.164 (95% CI=1.325-13.087, P =0.015) respectively. (Table 2)

Discussion: Our data does not support the use of probiotics to prevent IFALD in patients receiving prolonged parenteral support. Only small bowel length of 10-90 cm and prolonged HPN use showed a significant impact on IFALD.

Table 1. Patients characteristics

Table 2. Bivariable and multivariable analyses of the association between risk factors and IFALD.

Disclosures:

Mohammad Alomari indicated no relevant financial relationships.

Laith Al Momani indicated no relevant financial relationships.

Muhammad Talal Sarmini indicated no relevant financial relationships.

Bara El Kurdi indicated no relevant financial relationships.

Shrouq Khazaaleh indicated no relevant financial relationships.

Fredy Nehme indicated no relevant financial relationships.

Mark Young indicated no relevant financial relationships.

Carlos Romero-Marrero indicated no relevant financial relationships.

Citation: Mohammad Alomari, MD; Laith Al Momani, MD; Muhammad Talal Sarmini, MD; Bara El Kurdi, MD; Shrouq Khazaaleh, MD; Fredy Nehme, MD; Mark Young, MD; Carlos Romero-Marrero, MD, MSc. P0605 - EFFECTS OF PROBIOTICS ON INTESTINAL FAILURE-ASSOCIATED LIVER DISEASE IN ADULT PATIENTS RECEIVING PROLONGED PARENTERAL SUPPORT: A TERTIARY CARE CENTER EXPERIENCE. Program No. P0605. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.