Malnutrition is a common complication of end-stage liver disease, but is frequently not a priority of treatment before liver transplantation.
A study by members of the Duke University Medical center, Durham, North Carolina, USA, has now been conducted to examine whether prospective preoperative nutritional assessment can predict resource ultilization and outcome after liver transplantation.
Gerald R. Stephenson and colleagues retrospectively reviewed 109 sequential orthotopic liver transplants performed at the Duke University Medical Center over a 3-year period.
Patients with fulminant hepatic failure were excluded from the research, leaving a study population of 99 cases.
Nutritional status was determined at the time of transplantation using subjective global assessment, with results reported as median (interquartile range).
Intraoperative transfusion requirements of packed red blood cells and cryoprecipitate was higher in the patients with severe malnutrition in comparison to the mild and moderate groups.
|Nutritional repletion before transplantation could improve patient outcomes.|
The severe group required more fresh-frozen plasma interoperatively than the mild group.
Patients in the severe group had longer postoperative lengths of stay compared with patients in the moderate and mild groups.
The research team concludes that subjective global assessment is an excellent independent predictor of outcome in patients undergoing liver transplantation.
They add that if nutritional repletion is possible in patients with end-stage liver disease before transplantation, patient outcomes could be improved.