Impact of dietary intake and nutritional status on outcomes after liver transplantation.
OBJECTIVE
The aim of our study was to examine, in a prospective way, whether any nutritional parameter could predict outcomes after liver transplantation.


METHODS
A nutritional assessment was performed in 31 consecutive patients six months prior to undergoing orthotopic liver transplantation (OLT) at a single center (Hospital U. Río Hortega) and after six months of OLT (December 2002-June 2004). The nutritional evaluation included Subjective Global Assessment (SGA), Mini Nutritional Assessment test (MNA), anthropometry, laboratory tests, and three-day diet diary completed. The body composition analysis was performed by tetrapolar body electrical bioimpedance and skin folds in a standard way.


RESULTS
Our patients had an average age of 56.2 +/- 8.11 years; weight was 72.9 +/- 15.3 kg, and body mass index was 26.6 +/- 4.1. The anthropometric evaluation showed the following data: tricipital skin fold 12.2 +/- 6.1 mm, mid-arm circumference 24.5 +/- 4.1 cm, fat-free mass 54.5 +/- 10.9 kg, fat mass 18.4 +/- 6.5 mm, and body water 41.4 +/- 9.1 kg. After six months from liver transplantation, these parameters remained unchanged. Energy intake, as corrected by weight, was similar pre- and post-liver transplantation (28.1 +/- 6 kcal/kg vs. 27.5 +/- 5.8 kcal/kg: ns). Albumin, prealbumin and transferrin improved after 6 months from transplantation. Length of stay in hospital was 22.4 +/- 14.9 days, and length of stay in ICU was 0.7 +/- 1.7 days. The nutritional status (SGA and MNA tests) of patients did not influence length of stay in either hospital or ICU. No intercurrent events (infections: urinary tract infection, pneumonia, and peritonitis) were recorded during the 6-month study period. Two patients died after liver transplantation (6.5%), and 3 patients had acute rejection (9.6%). Patients with malnutrition (SGA and MNA tests classification) showed no differences in rejection and mortality.


CONCLUSIONS
Our liver transplantation population had normal nutritional status and dietary intake. Nutritional parameters showed no association with outcomes after liver transplantation. Liver transplantation improved serum protein levels and did not modify weight or dietary intake. Further studies are needed to clarify the role of liver transplantation on nutritional status and of nutritional status on liver transplantation outcomes, considering different populations of patients.
dadluis@yahoo.com
D A
DA
de Luis
O
O
Izaola
M C
MC
Velicia
G
G
Sánchez Antolín
F
F
García Pajares
M C
MC
Terroba
L
L
Cuellar
D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D009752:Nutritional Status; D016896:Treatment Outcome