Children who cannot eat on their own because of intestinal failure must rely on parenteral nutrition (PN), an intravenous method of feeding.
Unfortunately, long-term PN can cause life-threatening liver disease, especially in infants, for reasons that have been unknown. Many infants who develop this complication die within a year of diagnosis, unless they can be weaned off PN or receive a liver/small intestine transplant. In the July issue of Pediatrics, researchers at Children's Hospital Boston report saving two babies' lives - with one able to come off a liver-transplant list - simply by changing the type of fat used in the PN solution.
The story began in 2001 when, seeking to understand why PN was causing liver disease, surgeon Mark Puder, MD, surgical resident Jenna Garza, MD, and pharmacist Kathy Gura, PharmD, decided to conduct studies in mice. They found evidence that the fat used in standard PN solutions, called Intralipid., was contributing to liver disease by causing fat to accumulate in the liver.
Made largely of soybean oil, Intralipid is high in omega-6 fatty acids that are known to have an inflammatory effect. Puder's team decided to substitute OmegavenTM, an IV fat mixture made from fish oil. Fish oil contains omega-3 fatty acids, which have been shown to prevent fat accumulation and have anti-inflammatory properties. As hoped, PN using Omegaven as the fat prevented fat accumulation and liver injury in the mice.