title: Branched-chain amino acid-enriched nutrients improve nutritional and metabolic abnormalities in the early post-transplant period after living donor liver transplantation.
abstract: OBJECTIVE
  Malnutrition and metabolic disorder of patients undergoing living donor liver transplantation (LDLT) can affect post-transplant prognosis. The aim of this study was to establish whether perioperative usage of branched-chain amino-acid (BCAA)-enriched nutrients improve metabolic abnormalities of patients undergoing LDLT.
  
  
  METHODS
  We designed a randomized pilot study (UMIN registration number; 000004323). Twenty-five consecutive adult elective LDLT recipients were enroled and divided into two groups: the BCAA group (BCAA-enriched nutrients, n = 12) and the control group (standard diet, n = 13). Metabolic and nutritional parameters, including BCAA-to-tyrosine ratio (BTR), retinol binding protein (RBP), and prealbumin were regularly measured from 1 week before to 4 weeks after LDLT. Non-protein respiratory quotient (npRQ) was measured before and 4 weeks after LDLT.
  
  
  RESULTS
  BTR and RBP improved considerably in the BCAA group compared with the controls. npRQ significantly increased from 1 week before LDLT to 4 weeks after LDLT in the BCAA group (0.77 ± 0.05 to 0.84 ± 0.06, P = 0.002), but not in the control group (0.78 ± 0.04 to 0.81 ± 0.05).
  
  
  CONCLUSIONS
  Supplementation with BCAA-enriched nutrients might improve persistent nutritional and metabolic disorders associated with end-stage liver disease in the early post-transplant period, and consequently shorten the post-transplant catabolic phase after LDLT. A larger multicenter trial is needed to confirm these findings.
authors.affiliation: Department of Gastroenterological Surgery Transplant, and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. r9232001@yahoo.co.jp
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Yoshida
authors.forename: Takahito
authors.initials: T
authors.lastname: Yagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sadamori
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Susumu
authors.initials: S
authors.lastname: Shinoura
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Umeda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sato
authors.forename: Masashi
authors.initials: M
authors.lastname: Utsumi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagasaka
authors.forename: Nami
authors.initials: N
authors.lastname: Okazaki
authors.forename: Ai
authors.initials: A
authors.lastname: Date
authors.forename: Ayako
authors.initials: A
authors.lastname: Noguchi
authors.forename: Akemi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yachiyo
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D002153:Calorimetry, Indirect; D019587:Dietary Supplements; D004734:Energy Metabolism; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000378:metabolism* / Q000628:therapy*; D008115:Liver Regeneration; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010865:Pilot Projects; D011184:Postoperative Period; D011446:Prospective Studies
chemical_list: D000597:Amino Acids, Branched-Chain