title: Changes in nutritional status after liver transplantation.
abstract: Chronic liver disease has an important effect on nutritional status, and malnourishment is almost universally present in patients with end-stage liver disease who undergo liver transplantation. During recent decades, a trend has been reported that shows an increase in number of patients with end-stage liver disease and obesity in developed countries. The importance of carefully assessing the nutritional status during the work-up of patients who are candidates for liver replacement is widely recognised. Cirrhotic patients with depleted lean body mass (sarcopenia) and fat deposits have an increased surgical risk; malnutrition may further impact morbidity, mortality and costs in the post-transplantation setting. After transplantation and liver function is restored, many metabolic alterations are corrected, dietary intake is progressively normalised, and lifestyle changes may improve physical activity. Few studies have examined the modifications in body composition that occur in liver recipients. During the first 12 mo, the fat mass progressively increases in those patients who had previously depleted body mass, and the muscle mass recovery is subtle and non-significant by the end of the first year. In some patients, unregulated weight gain may lead to obesity and may promote metabolic disorders in the long term. Careful monitoring of nutritional changes will help identify the patients who are at risk for malnutrition or over-weight after liver transplantation. Physical and nutritional interventions must be investigated to evaluate their potential beneficial effect on body composition and muscle function after liver transplantation.
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Giusto
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lattanzi
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Di Gregorio
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Giannelli
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lucidi
authors.affiliation: Michela Giusto, Barbara Lattanzi, Vincenza Di Gregorio, Valerio Giannelli, Cristina Lucidi, Manuela Merli, II Gastroenterologia, Dipartimento di Medicina Clinica, "Sapienza" Università di Roma, 00185 Roma, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
mesh_terms: D001823:Body Composition; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D008659:Metabolic Diseases / Q000209:etiology / Q000503:physiopathology; D009752:Nutritional Status; D009765:Obesity / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain
keywords: Liver transplantation; Malnutrition; Metabolic syndrome; Obesity; Outcome; Sarcopenia; Survival