Nutrition support with glutamine dipeptide in patients undergoing liver transplantation.
OBJECTIVE
The effect of total parenteral nutrition (TPN) support supplemented with alanyl-glutamine (Ala-Gln) dipeptide was investigated in a randomized, controlled clinical trial.


METHODS
Sixty-five patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma admitted for orthotopic liver transplantation were randomly divided into 3 groups: diet group (n = 21), TPN group (n = 22), and Gln group (n = 22). Patients in the TPN and Gln groups received isocaloric and isonitrogenous TPN for 7 days. Venous heparin blood samples were obtained for assay on days 2 and 9 after surgery; we performed routine pathologic tests.


RESULTS
Compared with the results on day 9 in the TPN group, there was a significant increase in the prognostic nutrition index and in prealbumin among the Gln group. Aspartate aminotransferase improved significantly by Gln treatment compared with traditional TPN support (P < .05). The pathologic results also showed Gln supplementation to reduce hepatic cell injury. A significant decrease in postoperative hospital stay was observed in the Gln group.


CONCLUSIONS
Posttransplant TPN support greatly improved protein metabolism and nutritional state of patients. TPN with Ala-Gln helped to improve synthetic function and to reduce the injury to a transplanted liver.
Qiu
Y
Y
Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshang Road 321, Nanjing 210008, China. yudongqiu510@hotmail.com
Zhu
X
X
Wang
W
W
Xu
Q
Q
Ding
Y
Y
D000328:Adult; D001706:Biopsy; D001798:Blood Proteins / Q000032:analysis; D019587:Dietary Supplements; D004151:Dipeptides / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000473:pathology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D010289:Parenteral Nutrition, Total; D018579:Patient Selection; D011228:Prealbumin; D012709:Serum Albumin / Q000032:analysis; D014168:Transferrin / Q000378:metabolism
D001798:Blood Proteins; D004151:Dipeptides; D011228:Prealbumin; D012709:Serum Albumin; D014168:Transferrin; C054122:alanylglutamine