title: Markers of malnutrition after intestinal transplantation: the role of IGF-1 and calprotectin.
abstract: The objective of this study is to valuate two biomarkers that may guide nutritional assessment during follow up after intestinal transplantation. We performed a retrospective study on prospectively collected data of insulin-like growth factor-1 (IGF-1) and effluent calprotectin in patients undergoing intestinal transplantation. Optimal nutritional status (ONS) was defined by using the Malnutrition Universal Screening Tool (MUST). IGF-1 and calprotectin were correlated with ONS by Pearson correlation. Eighteen cadaveric intestinal transplants were performed over 1,650 days (median follow up 425 days, range 29-1,650 days). Mean IGF-1 and calprotectin were significantly associated with independent nutrition. Seven patients became malnourished on one or more occasions. During malnutrition the mean IGF-1 was 22 ± 14 ng/ml and calprotectin 1,597 ± 1,055 mcg/g. Mean weight during episodes of malnutrition changed from 64.77 ± 8.76 kg to 59.05 ± 8.5 kg (-8.9 ± 1.25%). Both IGF-1 and calprotectin negatively correlated with ONS (Pearson's r, -0.612, p = 0.014). Patients broadly aligned with three groups: nutritionally replete (normal IGF-1 and normal calprotectin), nutritionally equivocal (normal or low normal IGF-1 and high calprotectin), and malnourished (low IGF-1 and high calprotectin). Patients with low IGF-1 and high calprotectin may have a benign clinical presentation. However it is in their interests to have parenteral nutrition restarted pending further investigation.
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Georgios
authors: G
authors: Vrakas
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Marion
authors: M
authors: O'Connor
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Artemis
authors: A
authors: Matsou
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Rubens
authors: R
authors: Macedo Arantes
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Peter
authors: P
authors: Friend
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Srikanth
authors: S
authors: Reddy
authors: Oxford Transplant Centre, Oxford University Hospitals, OX3 7LE, UK.
authors: Anil
authors: A
authors: Vaidya
keywords: IGF-1; calprotectin; intestinal transplantation; nutritional status