title: Impact of nutritional status of Egyptian patients with end-stage liver disease on their outcomes after living donor liver transplantation.
abstract: OBJECTIVE
  Malnutrition is prevalent among patients with end-stage liver disease (ESLD) awaiting liver transplantation. Our aim was to examine prospectively the impact of patients' nutritional status on their outcomes after living donor liver transplantation (LDLT).
  
  
  METHODS
  In all, 30 patients scheduled for LDLT were subjected to a preoperative nutritional status assessment through subjective global assessment (SGA), nutritional risk screening (NRS 2002) and anthropometric measurements. All patients were followed up for 3 months after LDLT for mortality, graft rejection, number of clinically significant infective episodes, time spent in hospital (ward and intensive care unit [ICU]) and graft failure or dysfunction.
  
  
  RESULTS
  All patients were nutritionally compromised (evaluated by SGA and NRS 2002), and were divided into two groups: moderately and severely malnourished. Compared with moderately malnourished patients, severely malnourished patients showed significant postoperative hyperbilirubinemia, higher number of infective episodes and longer ICU stay. Preoperative triceps skinfold and mid-arm circumference were negatively correlated with the number of infective episodes (r = -0.33, P = 0.03 and r = -0.377, P = 0.04, respectively). Moreover, skeletal muscle mass was negatively correlated with postoperative serum alanine aminotransferase level (r = -0.52, P = 0.003) and the number of postoperative infective episodes (r = -0.3, P = 0.04).
  
  
  CONCLUSIONS
  Poor nutritional status of Egyptian patients with ESLD negatively affects the patients' outcomes after LDLT.
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: Yosry
authors.forename: Dalia
authors.initials: D
authors.lastname: Omran
authors.forename: Mohamad
authors.initials: M
authors.lastname: Said
authors.forename: Waleed
authors.initials: W
authors.lastname: Fouad
authors.forename: Osama
authors.initials: O
authors.lastname: Fekry
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: anthropometry; end stage liver disease; liver transplantation; nutritional risk screening 2002; subjective global assessment