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Nutrition in Patients Undergoing Orthotopic Liver Transplant
Author(s) -
Hehir Dermot J.,
Jenkins Roger L.,
Bistrian Bruce R.,
Blackburn George L.
Publication year - 1985
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607185009006695
Subject(s) - medicine , parenteral nutrition , gastroenterology , albumin , transplantation , transferrin , liver transplantation , malnutrition , serum albumin , calorie , anthropometry , liver disease , lymphocyte , surgery
Thirteen patients with severe liver disease had nutritional assessment in the weeks prior to orthotopic liver transplantation. Parameters measured included height and weight, upper arm anthropometry, delayed cutaneous hypersensitivity, total lymphocyte count, serum levels of albumin and transferrin, and plasma amino acids. Weight, when expressed as a percentage of ideal body weight, was greater than 85%, considered the normal lower limit, in all but two patients. However, mean triceps skinfold and arm muscle circumference were 49 ± 25 and 78 ± 9% standard, respectively. Mean serum albumin was 2.7 ± 0.6 g/dl and although mean serum transferrin level was 184 ± 86, eight patients had levels less than normal. Seven patients were anergic to Multitest CMI (58%) and 12 patients had depressed total lymphocyte count. All these later measurements in the aggregate support a diagnosis of protein‐calorie malnutrition. High preoperative levels of amino acids, especially aspartate, phenylalanine, tyrosine, and methionine, were returned to normal by transplantation. We conclude that protein‐calorie malnutrition is common in the group of patients likely to require liver transplant, although individual nutritional assessment parameters may lack sensitivity and specificity in determining nutritional status. (Journal of Parenteral and Enteral Nutrition 9 : 695–700, 1985)