Intestinal transplantation has become a standard treatment for intestinal failure in patients with life-threatening complications of TPN. Although the long-term survival of patients with continued parenteral nutrition is higher than after intestinal transplantation, the 1 and 2 year survival is comparable. Here we examine other aspects of the treatment options available for patients with intestinal failure including the cost of the therapy and the quality of life. The cost of parenteral nutrition compared to intestinal transplantation reveals that transplantation is cost-effective in patients that maintain graft function within 1 to 3 years after surgery. The quality of life after transplantation is probably equal to or better than quality of life on TPN and children report quality of life similar to normal school children. Although currently reserved for those with life-threatening complications, intestinal transplantation may soon be an option for any patient permanently dependent on parenteral nutrition.
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