Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Gastroenterology
Volume 14 (2000), Suppl D, Pages 85D-88D
http://dx.doi.org/10.1155/2000/919737
Mini-Review

Nutrition of Liver Transplant Patients

Arved Weimann,1 Mathias Plauth,2 Stefan C Bischoff,3 and Ernst R Kuse1

1Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover, Germany
2Medizinische Klinik mit Schwerpunkt Gastroenterologie/Hepatologie und Endokrinologie, Charité, Humboldt-Universität zu Berlin, Germany
3Abteilung Gastroenterologie und Hepatologie, Medizinische Hochschule, Hannover, Germany

Received 28 January 1999; Accepted 5 February 1999

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Good cooperation between the hepatologist, surgeon and anesthesiologist is required to determine the appropriate perioperative nutritional management for the liver transplant patient. For preoperative risk stratification, nutritional assessment according to resting energy expenditure by indirect calorimetry, and body cell mass by bioelectrical impedence analysis, may be superior to anthropometric parameters. When considering impaired glucose tolerance in the early postoperative period, requirements of energy intake and macronutrients are no different from those established in major abdominal surgery. Preference should be made to use the enteral route whenever possible. Fat emulsions containing medium- and long-chain triglycerides have neither a negative impact on reticulo-endothelial system recovery of the graft, nor any obvious metabolic advantages. There is no evidence for the routine use of branched-chain amino acids. Even in the case of good graft function, long term dietary evaluation and counselling may be useful. Impaired glucose tolerance, hyperlipidemia and hypercholesterolemia should be considered carefully. The role of preoperative nutritional therapy using oral supplements and the value of immune-enhancing substrates should be evaluated with special regard to a decrease in postoperative septic complications and for possible impact on immune tolerance after transplantation.