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

Abstract

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.

Keywords: anthropometry; end stage liver disease; liver transplantation; nutritional risk screening 2002; subjective global assessment.