Nutritional assessment and therapy in patients requiring liver transplantation.

Pretransplant nutritional assessment in the patient with ESLD is problematic. The best system for nutritional assessment uses a "global" evaluation of the patient's nutritional reserves. With such a technique, the vast majority of transplant candidates have been shown to have evidence of malnutrition. Several investigators have demonstrated the risk of significant malnutrition on posttransplant outcome. An aggressive approach to nutritional repletion is necessary to improve the ESLD patient's metabolic reserves, maintain remaining hepatic function, and better the outcome after liver transplantation.