2012 Volume 27 Issue 5 Pages 1229-1237
Objectives: Protein-energy malnutrition is common in patients with end-stage liver disease requiring liver transplantation, and is a risk factor for post-transplant morbidity including sepsis. We therefore investigated the significance of pretransplant nutritional treatment on the pretransplant nutritional status and post-transplant bacteremia in patients undergoing living donor liver transplantation (LDLT).
Methods: We retrospectively analyzed 60 recipients who underwent LDLT and in whom we could measure various nutritional parameters, including the total lymphocyte count, prealbumin, zinc, and ammonia levels, between January 2009 and January 2011. We compared the changes of nutritional parameters and incidence of post-transplant bacteremia between 33 patients who received pretransplant nutritional treatment including a branched chain amino acid-enriched nutrient mixture, synbiotics, and zinc (Treatment group) and 27 patients who did not receive such treatment (Non-treatment group).
Results: The total lymphocyte count, serum prealbumin, C-reactive protein, and zinc levels in the Treatment group were significantly improved compared with those in the Non-treatment group. The incidence of post-transplant bacteremia in the Treatment group showed a decreasing tendency compared with that in the Non-treatment group. In the Treatment group, there was a significant correlation between the serum zinc level and serum ammonia levels (p=0.001).
Conclusions: Pretransplant nutritional treatment has potent impacts on the improvement of the pretransplant nutritional status and probably has an inhibitory effect on the post-transplant bacteremia.
