During use of home parenteral nutrition, chronic abnormalities on liver function tests are reported to occur in both children and adults at a rate ranging from 15% to 85% (1 - 6). The pathogenesis of home parenteral nutrition-related liver disease, which presents mainly as chronic intrahepatic cholestasis with or without jaundice, is multifactorial and involves patient-dependent factors, especially the short-bowel syndrome (2,5 - 7), and nutrition-dependent factors, such as intravenous hyperalimentation (1,8). Other factors involved are intestinal bacterial overgrowth and translocation (9 - 10) and disruption of the enterohepatic bile acid pool with the occurrence of deconjugated toxic bile acids (1,8). During the early months of home parenteral nutrition-related liver disease, histologic abnormalities consist of canalicular cholestasis and portal inflammation with or without fatty infiltration. Later, severe histologic changes—namely, extensive portal fibrosis or cirrhosis—have been anecdotally reported; over months and years, these conditions lead to liver failure and death (2,5 - 6,11 - 13).