{"id":47386,"date":"2001-08-08T00:00:00","date_gmt":"2001-08-08T05:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/2001\/08\/08\/nhs-and-unmc-launch-new-intestinal-rehabilitation-program\/"},"modified":"2022-08-29T10:51:53","modified_gmt":"2022-08-29T15:51:53","slug":"nhs-and-unmc-launch-new-intestinal-rehabilitation-program","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2001\/08\/08\/nhs-and-unmc-launch-new-intestinal-rehabilitation-program\/","title":{"rendered":"NHS and UNMC Launch New Intestinal Rehabilitation Program"},"content":{"rendered":"

Nebraska Health System (NHS) and the University of Nebraska Medical<\/p>\n

Center (UNMC) are expanding their world-renowned intestinal failure and<\/p>\n

transplantation programs with the creation of a new Intestinal Rehabilitation<\/p>\n

Program.  This new initiative will be started in partnership with<\/p>\n

the Nutritional Restart Center (NRC) of Hopkinton, Mass., and will be located<\/p>\n

in Omaha.<\/p>\n

The new program will open to patients in August. It will offer patients<\/p>\n

with intestinal failure comprehensive treatment options to help them transition<\/p>\n

from total parenteral nutrition (TPN) to a more normal oral diet.<\/p>\n

TPN is used to provide calories and nutrition intravenously for a patient<\/p>\n

whose intestinal tract cannot digest or absorb nutrients normally. <\/p>\n

Intestinal failure often means long-term and sometimes permanent dependence<\/p>\n

upon TPN.  Without TPN, the patients would become dehydrated, under<\/p>\n

nourished and eventually die.<\/p>\n

The principle cause of intestinal failure is short bowel syndrome, which<\/p>\n

can result from injury, disease or as a result of surgical treatment of<\/p>\n

complex intestinal conditions.  In the past, patients often remained<\/p>\n

dependent on TPN.  A small minority of patients may benefit from surgical<\/p>\n

procedures on their bowel, such as intestinal lengthening, tapering or<\/p>\n

creation of reversed segments.  In some patients it becomes impossible<\/p>\n

or dangerous to continue TPN in the long term because of development of<\/p>\n

life-threatening complications such as liver disease or central venous<\/p>\n

catheter infections.<\/p>\n

In the last few years, it has become apparent that patients who do not<\/p>\n

tolerate TPN in the long term may enjoy an improved quality of life with<\/p>\n

intestinal transplantation.  Whatever the underlying reason for intestinal<\/p>\n

failure, the goal of the new program is to improve the function of the<\/p>\n

remaining bowel by employing unique, innovative and non-invasive strategies<\/p>\n

pioneered at the NRC.<\/p>\n

The ability to offer patients with intestinal failure a non-invasive<\/p>\n

alternative to all the other treatment options we currently employ at NHS<\/p>\n

and UNMC is a significant addition to our intestinal failure and transplant<\/p>\n

programs, said Kishore Iyer, M.D., director of the new program. <\/p>\n

In addition to optimizing the medical management of these patients, the<\/p>\n

Intestinal Rehabilitation Program will teach patients what to eat and drink<\/p>\n

and how to incorporate this new knowledge into their lifestyle once they<\/p>\n

return home.  The ultimate goal is to wean patients slowly from TPN<\/p>\n

and improve their overall quality of life.   An obvious benefit<\/p>\n

will be the reduction and prevention of some of the recognized complications<\/p>\n

associated with long-term TPN.<\/p>\n

Over the past eight years, the NRC has treated nearly 400 patients,<\/p>\n

representing the largest single experience in the area of intestinal rehabilitation<\/p>\n

in the world, said Theresa Byrne, Ph.D. of the Massachusetts Center. <\/p>\n

With an average follow-up period of two years, our studies have shown<\/p>\n

that following intensive treatment at our center, about 40 percent of patients<\/p>\n

are able to remain off TPN and another 40 percent experience a significant<\/p>\n

reduction in their need for intravenous feedings.  The success and<\/p>\n

growth of our program, coupled with the complexity of the medical issues<\/p>\n

confronting many of the patients, forced us to look for a new home that<\/p>\n

could offer patients a full spectrum of services and interventions. <\/p>\n

What we found at NHS and UNMC is ideal both in terms of clinical staff<\/p>\n

and facilities.  This one-stop comprehensive team approach to intestinal<\/p>\n

failure means that we are now in a position to offer the most appropriate<\/p>\n

therapy for the patient with intestinal failure, without being restricted<\/p>\n

to one form of therapy or another.<\/p>\n

Patients coming in to the Intestinal Rehabilitation Program in Omaha<\/p>\n

will be admitted to Cooperative Care rooms in The Lied Transplant Center<\/p>\n

with nutritional instruction and demonstrations taking place in the Cooperative<\/p>\n

Care dining room.  The clinical progress of the patients will be monitored<\/p>\n

daily by a team of physicians, nurses, dietitians and other health-care<\/p>\n

professionals, all of whom have a special interest and long-standing experience<\/p>\n

in management of TPN and intestinal failure.<\/p>\n

The team at NHS and UNMC has, over the years, evaluated and managed<\/p>\n

about 300 patients with intestinal failure and performed more than 120<\/p>\n

intestinal transplant operations, said Alan Langnas, D.O., chief of transplantation<\/p>\n

at NHS and UNMC.  This represents close to a third of the world experience<\/p>\n

in intestinal transplantation.  By joining forces with the NRC and<\/p>\n

creating the new rehabilitation program we will provide our intestinal<\/p>\n

failure patients a continuum of care they wont find anywhere else. We<\/p>\n

can offer patients non-invasive treatments and if those fail, evaluate<\/p>\n

them for a range of surgical procedures the last of which is transplantation.<\/p>\n

Our goal will be to assist patients back to a more normal life.  Thats<\/p>\n

very exciting for us and more importantly for our patients, Dr. Langnas<\/p>\n

added.<\/p>\n

The Intestinal Failure Clinic at NHS and UNMC, which was established<\/p>\n

about 10 months ago, sees two to three patients with intestinal failure<\/p>\n

each week.  Patients are assessed for intestinal disease, liver problems,<\/p>\n

dietary management and in some cases for reconstructive surgical options. <\/p>\n

Through a multi-disciplinary team approach, the clinic has already had<\/p>\n

considerable success in weaning patients from TPN and even avoiding the<\/p>\n

need for intestinal transplantation in some cases, said Dr. Iyer. <\/p>\n

Where early evaluation for intestinal transplantation is appropriate,<\/p>\n

this can be carried out immediately.  The new Intestinal Rehabilitation<\/p>\n

Program will aim to build on the early success of the Intestinal Failure<\/p>\n

Clinic and on the premier international reputation of our intestinal and<\/p>\n

liver transplantation programs, Dr. Iyer added.<\/p>\n

The new rehabilitation program projects an average of six patients going<\/p>\n

through the 14 to 26 day in-patient treatment plan at one time.  In<\/p>\n

addition to their medical, nutritional and nursing teams, patients have<\/p>\n

the added benefit of a care partner who they select.  That partner<\/p>\n

can be a spouse, parent, relative or friend.  That is the beauty of<\/p>\n

the Cooperative Care philosophy, allowing patients a level of independence<\/p>\n

and comfort, not routinely associated with hospitals.<\/p>\n

Physicians at Harvard Medical School and Brigham and Womens Hospital<\/p>\n

started the NRC program about eight years ago.  Going forward, collaborative<\/p>\n

research efforts will be focused in both Boston and in Omaha.  The<\/p>\n

ability to offer patients access to innovative research and this complete<\/p>\n

continuum of care speaks well to our intestinal failure and transplant<\/p>\n

programs, said Dr. Langnas.<\/p>\n

The NHS and UNMC intestinal transplantation program is one of only four<\/p>\n

in the United States to be approved for coverage by Medicare.  While<\/p>\n

interest in<\/p>\n

intestinal transplantation is clearly on the increase, we believe it<\/p>\n

is just as important to focus our efforts on developing non-invasive and<\/p>\n

simpler medical and surgical options that may be more appropriate than<\/p>\n

transplantation for some patients with intestinal failure, says Dr. Iyer. <\/p>\n

Nationwide, approximately 50 private insurers have approved the NRC rehabilitation<\/p>\n

program.<\/p>\n

For more information on the Intestinal Rehabilitation Program, you can<\/p>\n

log onto any of the following web sites: www.nebraskahealthsystem.com,<\/p>\n

www.unmc.edu, or  www.nrcenter.com.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

Nebraska Health System (NHS) and the University of Nebraska Medical Center (UNMC) are expanding their world-renowned intestinal failure and transplantation programs with the creation of a new Intestinal Rehabilitation Program.  This new initiative will be started in partnership with the Nutritional Restart Center (NRC) of Hopkinton, Mass., and will be located in Omaha. The new […]<\/p>\n","protected":false},"author":79,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-47386","post","type-post","status-publish","format-standard","hentry","category-uncategorized","department-press-release"],"yoast_head":"\nNHS and UNMC Launch New Intestinal Rehabilitation Program<\/title>\n<meta name=\"description\" content=\"Nebraska Health System (NHS) and the University of Nebraska Medical Center (UNMC) are expanding their world-renowned 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