Kim Jong Man, Joh Jae-Won, Kim Hyun Jung, Kim Sung-Hye, Rha Miyong, Sinn Dong Hyun, Choi Gyu-Seong, Kwon Choon Hyuck David, Cho Young Yun, Suh Jeong-Meen, Lee Suk-Koo
From the Department of Surgery, Sungkyunkwan University School of Medicine (JMK, J-WJ, HJK, G-SC, CHDK, J-MS, S-KL); Department of Dietetics (S-HK, MR, YYC); and Division of Gastroenteology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea (DHS).
Medicine (Baltimore). 2015 Nov;94(44):e1771. doi: 10.1097/MD.0000000000001771.
Infectious complications, including bacteria, virus, and fungus, often occur after liver transplantation and are the most frequent causes of in-hospital mortality. The current study prospectively analyze the effect of early enteral feeding in patients after living donor liver transplantation (LDLT)Between January 2013 and August 2013, 36 patients underwent LDLT. These patients were randomly assigned to receive enteral formula via nasointestinal feeding tubes [enteral feeding (EN) group, n = 17] or maintenance on intravenous fluid until oral diets were initiated (control group, n = 19). All patients completed the study.The pretransplant and perioperative characteristics of patients did not differ between the 2 groups. The incidence of bacterial infection was significantly lower in the EN group (29.4%) than in the control group (63.2%) (P = 0.043). In addition, the incidence of bile duct complications in the EN group was lower than in the control group (5.9% versus 31.6%, P = 0.041). Multivariate analysis showed that early enteral feeding was closely associated with bacterial infections (odds ratio, 0.178; P = 0.041). There was no statistically significant difference in nutritional status between the 2 groups. There were no cases of in-hospital mortality.Early enteral feeding after LDLT prevents posttransplant bacterial infection, suggesting the possibility of a reduction of in-hospital mortality as a result of decreased infectious complications.
包括细菌、病毒和真菌在内的感染性并发症,常在肝移植后发生,并且是院内死亡的最常见原因。本研究前瞻性分析了活体肝移植(LDLT)术后患者早期肠内营养的效果。在2013年1月至2013年8月期间,36例患者接受了LDLT。这些患者被随机分配通过鼻肠饲管接受肠内配方营养(肠内营养组,n = 17)或维持静脉输液直至开始经口饮食(对照组,n = 19)。所有患者均完成了研究。两组患者移植前和围手术期的特征无差异。肠内营养组的细菌感染发生率(29.4%)显著低于对照组(63.2%)(P = 0.043)。此外,肠内营养组的胆管并发症发生率低于对照组(5.9% 对31.6%,P = 0.041)。多因素分析显示,早期肠内营养与细菌感染密切相关(比值比,0.178;P = 0.041)。两组患者的营养状况无统计学显著差异。无院内死亡病例。LDLT术后早期肠内营养可预防移植后细菌感染,提示因感染性并发症减少而降低院内死亡的可能性。