title: Perioperative changes in nutritional parameters and impact of graft size in patients undergoing adult living donor liver transplantation.
abstract: Derangements of various serum biochemical nutritional/metabolic parameters are common in patients with end-stage liver disease who undergo liver transplantation (LT). The aim of this study was to explain the benefit of LT with respect to parameter changes and to examine the impact of the graft-to-recipient weight ratio (GRWR) on such changes. We investigated each parameter's course in 208 adult recipients for 1 year after living donor LT and analyzed changes in the parameters with a GRWR of 0.8% as the cutoff point. Bonferroni corrections were applied to account for multiple testing. Liver disease-induced high pretransplant ammonia and tyrosine levels and low branched-chain amino acids to tyrosine ratio (BTR) and zinc levels normalized within 2 weeks after transplantation, and the total lymphocyte count (TLC) normalized within 2 months, whereas low pretransplant prealbumin levels took 1 year to normalize. Branched-chain amino acids (BCAA), zinc, and TLC levels transiently dropped shortly after transplantation and then were corrected later. An accelerated recovery of ammonia and tyrosine levels and the BTR were found with larger grafts, especially early after transplantation, whereas zinc, prealbumin, BCAA, and TLC levels recovered regardless of the graft size. In conclusion, graft size had little effect on the recovery of nutritional/metabolic parameters except for ammonia and tyrosine levels.
authors.affiliation: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hammad
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Koji
authors.initials: K
authors.lastname: Tomiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Uemura
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000737:chemistry; D000641:Ammonia / Q000737:chemistry; D001787:Blood Group Incompatibility; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D009752:Nutritional Status; D059035:Perioperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014443:Tyrosine / Q000737:chemistry; D055815:Young Adult; D015032:Zinc / Q000737:chemistry
chemical_list: D000017:ABO Blood-Group System; D000597:Amino Acids, Branched-Chain; D007166:Immunosuppressive Agents; D014443:Tyrosine; D000641:Ammonia; D015032:Zinc