Role of nutrition in liver transplantation for end-stage chronic liver disease.
Patients with end-stage liver disease often reveal significant protein-energy malnutrition, which may deteriorate after listing for transplantation. Since malnutrition affects post-transplant survival, precise assessment must be an integral part of pre- and post-surgical management. While there is wide agreement that aggressive treatment of nutritional deficiencies is required, strong scientific evidence supporting nutritional therapy is sparse. In practice, oral nutritional supplements are preferred over parenteral nutrition, but enteral tube feeding may be necessary to maintain adequate calorie intake. Protein restriction should be avoided and administration of branched-chain amino acids may help yield a sufficient protein supply. Specific problems such as micronutrient deficiency, fluid balance, cholestasis, encephalopathy, and comorbid conditions need attention in order to optimize patient outcome.
Stickel
Felix
F
Institute of Clinical Pharmacology, Inselspital, University of Berne, Berne, Switzerland. felix.stickel@ikp.unibe.ch
Inderbitzin
Daniel
D
Candinas
Daniel
D
D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation; D015596:Nutrition Assessment; D044623:Nutrition Therapy; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D011182:Postoperative Care; D011300:Preoperative Care; D011502:Protein-Energy Malnutrition / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*