Yosry Ayman, Omran Dalia, Said Mohamad, Fouad Waleed, Fekry Osama
Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Dig Dis. 2014 Jun;15(6):321-6. doi: 10.1111/1751-2980.12141.
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).
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.
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).
Poor nutritional status of Egyptian patients with ESLD negatively affects the patients' outcomes after LDLT.
营养不良在等待肝移植的终末期肝病（ESLD）患者中普遍存在。我们的目的是前瞻性地研究患者营养状况对其活体肝移植（LDLT）术后结局的影响。
共有30例计划接受LDLT的患者通过主观全面评定法（SGA）、营养风险筛查（NRS 2002）和人体测量进行术前营养状况评估。所有患者在LDLT术后随访3个月，观察死亡率、移植排斥反应、具有临床意义的感染发作次数、住院时间（病房和重症监护病房[ICU]）以及移植失败或功能障碍情况。
所有患者均存在营养不足（通过SGA和NRS 2002评估），并分为两组：中度和重度营养不良。与中度营养不良患者相比，重度营养不良患者术后出现明显高胆红素血症、感染发作次数更多且ICU住院时间更长。术前肱三头肌皮褶厚度和上臂围与感染发作次数呈负相关（分别为r = -0.33，P = 0.03和r = -0.377，P = 0.04）。此外，骨骼肌质量与术后血清丙氨酸氨基转移酶水平呈负相关（r = -0.52，P = 0.003）以及与术后感染发作次数呈负相关（r = -0.3，P = 0.04）。
埃及ESLD患者的营养状况不佳对LDLT术后患者的结局产生负面影响。
