Nutrition of Liver Transplant Patients
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 cal...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2000-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2000/919737 |
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| Summary: | 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. |
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| ISSN: | 0835-7900 |