title: Pre- and postoperative nutritional assessment and health-related quality of life in recipients of living donor liver transplantation.
abstract: OBJECTIVE
  The nutritional state of living donor liver transplantation (LDLT) recipients is one of the most important factors affecting postoperative outcome. Although the assessment of health-related quality of life (HRQOL) is of increasing importance, few studies have examined this in conjunction with LDLT recipient nutritional state.
  
  
  METHODS
  Ten LDLT recipients with end-stage liver disease were recruited for this study. Measurements of energy expenditure, anthropometrics and laboratory data were performed before and 1, 6 and 12-24 months after LDLT. HRQOL was measured by using the 36-item Short-Form (SF-36) before and 1, 3, 6 and 12-24 months after LDLT.
  
  
  RESULTS
  The preoperative value of non-protein respiratory quotient (npRQ) was 0.796 ± 0.026 and it increased significantly after the operation. Serum non-esterified fatty acid (NEFA) levels were high in the preoperative state, but had significantly decreased 1 month after the operation. A negative correlation between npRQ and NEFA was observed throughout the study period. Cholinesterase and albumin levels improved to normal levels within 6 and 12-24 months, respectively. The recovery of the physical component summary of the SF-36 was observed after the improvement of all domains of laboratory data and energy metabolism based on the nutritional state.
  
  
  CONCLUSIONS
  This study demonstrated that the recovery of metabolic function, laboratory data and HRQOL in LDLT recipients are variable, and it took more than 6 months to normalize the liver protein synthetic capacity and physical HRQOL score periods. Therefore, long-term nutritional support is required in LDLT recipients.
authors.affiliation: Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Urano
authors.forename: Hisami
authors.initials: H
authors.lastname: Yamanaka-Okumura
authors.forename: Arisa
authors.initials: A
authors.lastname: Teramoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Sugihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Eiji
authors.initials: E
authors.lastname: Takeda
keywords: energy metabolism; living donor liver transplantation; non-protein respiratory quotient; nutritional assessment; quality of life