Pre-operative nutritional support in children with end-stage liver disease accepted for liver transplantation: an approach to management.
Pre-operative nutritional support was studied in 28 children with end-stage liver disease awaiting orthotopic liver transplantation. Nasogastric supplemental administration of a standard semi-elemental enteral nutritional formula was compared with a similar formula enriched with branched chain amino acids, and with a group receiving oral nutrition only. The duration of treatment in all groups was similar (mean 90 days). Energy intakes in the supplemented groups were 120-150% of recommended daily intakes (RDI), whereas ad libitum intakes in the oral group ranged 58-100% RDI. A significant improvement in mean Z-score for body weight (denoting catch-up) was noted only in those children who received nasogastric supplements enriched with branched-chain amino acids. The standard enterally-fed group maintained their body weight and Z-scores did not change significantly. In contrast, body weight Z-scores in those fed orally declined significantly. Nutritional supportive therapy of malnourished children with end-stage liver disease can minimize or improve nutritional status in children awaiting liver transplantation. The use of nutritional formulae rich in branched-chain amino acids may have nutritional advantages in children with chronic liver disease which require further study and evaluation.
Chin
S E
SE
Department of Gastroenterology and Nutrition, Royal Children's Hospital, Brisbane, Australia.
Shepherd
R W
RW
Cleghorn
G J
GJ
Patrick
M
M
Ong
T H
TH
Wilcox
J
J
Lynch
S
S
Strong
R
R
D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage; D001656:Biliary Atresia / Q000601:surgery*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D009748:Nutrition Disorders / Q000628:therapy*; D009752:Nutritional Status; D011300:Preoperative Care
D000597:Amino Acids, Branched-Chain