肝移植術後回復における早期栄養投与量の意義

抄録

【Objective】We investigated the significance of early nutritional administration for one week after living donor liver transplantation (LDLT).
【Methods】We retrospectively analyzed 62 patients who underwent adult LDLT in our center from January 2013 to November 2015. We compared nutritional statuses, immunological functions, and muscle masses between patients who received recommended calories (recommendation group, equal or more than 20k cal/kg ideal body weight, n = 38) and patients who did not receive recommended calories (non-recommendation group, less than 20k cal/kg ideal body weight, n = 24) for 1 week after LDLT.
【Results】Psoas muscle mass index (PMI), prealbumin, branched-chain amino acids, eicosapentaenoic acid (EPA), the ratio of EPA to arachidonic acid (EPA/AA ratio), and total lymphocyte count (TLC) on admission did not differ significantly between the recommendation group and the nonrecommendation group. The EPA, EPA/AA ratio, and TLC at 2 weeks after LDLT were significantly higher in the recommendation group than in the nonrecommendation group (p = 0.014, p = 0.040, p = 0.016, respectively). A percent against standard skeletal muscle mass in the recommendation group was significantly higher than that in the nonrecommendation group (p = 0.020). Postoperative hospital stay was significantly shorter in the recommendation group compared with the nonrecommendation group （p < 0.010）. A significant positive relationship was found between the total calories as well as protein administration for one week after LDLT and a percent against standard skeletal muscle mass (p = 0.008, p = 0.013, respectively).
【Conclusion】Sufficient nutritional administration during the early period after LDLT contributed to an early recovery of nutritional status, immunological function, and muscle mass.