Impact of nutritional status of Egyptian patients with end-stage liver disease on their outcomes after living donor liver transplantation.

OBJECTIVE

Malnutrition is prevalent among patients with end-stage liver disease (ESLD) awaiting liver transplantation. Our aim was to examine prospectively the impact of patients' nutritional status on their outcomes after living donor liver transplantation (LDLT).

METHODS

In all, 30 patients scheduled for LDLT were subjected to a preoperative nutritional status assessment through subjective global assessment (SGA), nutritional risk screening (NRS 2002) and anthropometric measurements. All patients were followed up for 3 months after LDLT for mortality, graft rejection, number of clinically significant infective episodes, time spent in hospital (ward and intensive care unit [ICU]) and graft failure or dysfunction.

RESULTS

All patients were nutritionally compromised (evaluated by SGA and NRS 2002), and were divided into two groups: moderately and severely malnourished. Compared with moderately malnourished patients, severely malnourished patients showed significant postoperative hyperbilirubinemia, higher number of infective episodes and longer ICU stay. Preoperative triceps skinfold and mid-arm circumference were negatively correlated with the number of infective episodes (r = -0.33, P = 0.03 and r = -0.377, P = 0.04, respectively). Moreover, skeletal muscle mass was negatively correlated with postoperative serum alanine aminotransferase level (r = -0.52, P = 0.003) and the number of postoperative infective episodes (r = -0.3, P = 0.04).

CONCLUSION

Poor nutritional status of Egyptian patients with ESLD negatively affects the patients' outcomes after LDLT.