Department of Medicine, Division of Gastroenterology and Hepatology, Federal University of São Paulo, Brazil.
J Gastroenterol Hepatol. 2010 Feb;25(2):391-6. doi: 10.1111/j.1440-1746.2009.06033.x. Epub 2009 Nov 19.
Most studies published focus on the evaluation of the impact of nutritional status on the morbidity and mortality during the immediate postoperative period or on the short-term evolution of liver transplant patients. The aim of the study was to evaluate long-term trends in nutritional status.
Seventy patients consecutively submitted to liver transplantation were studied. Nutritional assessment was performed the day before transplantation and the 45, 90, 180 and 365 days after transplantation, consisting of determination of dietary intake, anthropometric and biochemical analysis.
Sixty-nine percent of the patients presented with malnutrition on the day before liver transplantation, decreasing to 44% at end of the first year. The prevalence of protein-calorie malnutrition (PCM) was 63% at 90 days post-transplant. A significant difference of PCM was observed between patients with cirrhosis and non-cirrhotic disease (53.6% x 100%) at 90 days post-transplant. The pre-transplant nutritional diagnosis and 90-day calorie intake were identified as variables independently associated with nutritional status at 90 days post-transplant. The variables independently associated with nutritional status in the 1-year assessment were pre-transplant PCM and 365-day calorie requirements.
No influence on nutritional status was observed for peri- or postoperative factors after 3 or 12 months of follow up. As expected, dietary factors, especially adequate calorie intake, were always associated with nutritional status during all periods analyzed.
大多数已发表的研究都集中在评估营养状况对肝移植患者术后即刻期和短期的发病率和死亡率的影响。本研究旨在评估营养状况的长期趋势。
连续对 70 例肝移植患者进行研究。在移植前一天以及移植后第 45、90、180 和 365 天进行营养评估,包括饮食摄入、人体测量学和生化分析。
69%的患者在肝移植前一天存在营养不良,在第一年结束时降至 44%。在移植后第 90 天,蛋白质-热量营养不良(PCM)的患病率为 63%。在移植后第 90 天,肝硬化和非肝硬化患者之间的 PCM 存在显著差异(53.6%x100%)。移植前的营养诊断和 90 天的热量摄入被确定为与移植后第 90 天营养状况独立相关的变量。在 1 年评估中,与营养状况独立相关的变量是移植前的 PCM 和 365 天的热量需求。
在 3 或 12 个月的随访后,围手术期或术后因素对营养状况没有影响。正如预期的那样,饮食因素,尤其是充足的热量摄入,在所有分析期间始终与营养状况相关。