Prolonged use of soybean-oil (SO) based lipid emulsions in parenteral nutrition (PN) may contribute to the development of PN-associated liver disease (PNALD). Current research suggests a role for mixed-lipid emulsions in preventing, treating, or managing PNALD in acute-care settings. The use of mixedlipid emulsions and their effects on liver function tests (LFTs) in adults receiving home PN (HPN) has not been widely studied.

To describe demographic and clinical characteristics of BC HPN patients who have transitioned from Intralipid®, a SO-lipid emulsion, to MOFlipid®, a mixed-oil emulsion, and to describe any changes with regards to LFTs before and after transition to SMOFlipid®.

A retrospective chart review was completed for BC HPN patients who transitioned from Intralipid® to SMOFlipid® and were active between January 1/13 and October 31/17. Data collected included demographic and clinical information, HPN prescription details, and monthly measurements of FTs before and after lipid transition. Data was analyzed using descriptive statistics.

19 patients constituted the study group; 6 could not be analyzed, and 3 were outliers, leaving 10 for analysis. The most frequent indication for HPN was short bowel syndrome (SBS) (90%, n=9). 50% of participants showed signs of liver injury on Intralipid®. After transition to SMOFlipid®, 50% of the study population had decreases in their mean value of all four LFTs, however the degree of change varied.

Overall, LFTs declined after transition to SMOFlipid®. These findings are consistent with studies observing effects of SMOFlipid® on LFTs; however, most compare SO-based and mixed-lipid intravenous lipid emulsions (ILEs) in acute or surgical settings.

No other studies have looked at a transition from Intralipid® to SMOFlipid® in the HPN population. Further understanding of the long-term impact of mixed ILEs will help to inform whether SMOFlipid® should be considered for primary prevention of PNALD for BC HPN patients.