Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation.
Nutritional assessment factors (including dietary history, anthropometric and biochemical measurements, and evaluation of immunocompetence) were retrospectively reviewed in 74 patients undergoing an initial liver transplantation procedure. The patients were subdivided into four categories on the basis of type of liver disease: chronic active hepatitis (N = 24), primary sclerosing cholangitis (N = 22), primary biliary cirrhosis (N = 20), and acute or subacute hepatitis (N = 8). Our nutritional assessment data indicated that malnutrition was present preoperatively in all liver transplantation groups but that each group had distinct characteristics. The group with primary biliary cirrhosis seemed to have the best hepatic synthetic function despite extreme wasting of muscle and fat. On the basis of all criteria, the group with acute hepatitis was the most malnourished of the various disease groups. Aggressive nutritional support, which includes adequate intake of nutrients and supplementation of vitamins and trace minerals, should be encouraged for all potential liver transplant patients.
DiCecco
S R
SR
Department of Dietetics, Rochester Methodist Hospital.
Wieners
E J
EJ
Wiesner
R H
RH
Southorn
P A
PA
Plevak
D J
DJ
Krom
R A
RA
D000328:Adult; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000209:etiology