title: Beneficial effects of supplementation with branched-chain amino acids on postoperative bacteremia in living donor liver transplant recipients.
abstract: The aim of this study was to investigate the effects of preoperative oral supplementation with branched-chain amino acids (BCAAs) on postoperative bacteremia after living donor liver transplantation (LDLT) for chronic liver failure. Two hundred thirty-six patients who underwent adult-to-adult LDLT were evaluated in this retrospective study. The patients were divided into 2 groups: those who received oral supplementation with BCAAs before transplantation (the BCAA group; n = 129) and those who did not (the non-BCAA group; n = 107). Before the LDLT indication was determined, BCAA supplementation was prescribed by a hepatologist to preserve hepatic reserves. The clinical characteristics and the incidence of bacteremia were compared between the 2 groups. As for clinical characteristics, the Child-Pugh scores (P = 0.0003) and the Model for End-Stage Liver Disease scores (P = 0.0008) were significantly higher in the BCAA group versus the non-BCAA group. The incidence of bacteremia for Child-Pugh class C patients was significantly lower in the BCAA group (6/90 or 6.7%) versus the non-BCAA group (11/50 or 22.0%, P = 0.0132). In a multivariate analysis, non-BCAA supplementation was an independent risk factor for bacteremia. In conclusion, preoperative BCAA supplementation might reduce the incidence of bacteremia after LDLT. Nevertheless, this is a preliminary report, and further studies, such as randomized, prospective studies, are necessary to clarify the beneficial effects of BCAA supplementation on postoperative bacteremia after liver transplantation.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kshirabe@surg2.med.kyushu-u.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshimatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Motomura
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takeishi
authors.forename: Takeo
authors.initials: T
authors.lastname: Toshima
authors.forename: Jun
authors.initials: J
authors.lastname: Muto
authors.forename: Rumi
authors.initials: R
authors.lastname: Matono
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D016470:Bacteremia / Q000378:metabolism*; D001706:Biopsy; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000597:Amino Acids, Branched-Chain