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Case Reports
. 2020 Jul 18;8(10):2055-2059.
doi: 10.1002/ccr3.3060. eCollection 2020 Oct.

Malnutrition and chyle leakage: A life-threatening duo in heart transplantation post-Fontan procedure

Antonella Lezo  1 , Enrico Aidala  2 , Luca Deorsola  2 , Maria Teresa Cascarano  2 , Alberta Rizzo  3 , Stefania Iannandrea  3 , Licia Peruzzi  4 , Federica Runfola  5 , Carlo Pace Napoleone  2
Affiliations
Case Reports

Malnutrition and chyle leakage: A life-threatening duo in heart transplantation post-Fontan procedure

Antonella Lezo et al. Clin Case Rep. .

Abstract

Protein-losing enteropathy and chyle leakage may lead to severe malnutrition in heart transplantation for failing Fontan. Nutritional management may be challenging from defining nutrient needs to diagnosis of malnutrition enteropathy, and expertise is necessary. Body composition and hematological nutritional indices may help define malnutrition severity and guide nutritional strategy.

Keywords: chyle leakage; failing Fontan; intestinal failure; malnutrition.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Observed body composition parameters: fat‐free mass—FFM (kg); body cell mass—BCM (kg); extracellular water—ECW (% of total body water); nutritional hematological indices: prealbumin (mg/dL) and cholinesterase—CHE (IU/L), energy, and protein intake provided by parenteral nutrition (PN) and oral alimentation. ↔, stable PN; ↑, increase; ↓, decrease; CVVHDF, continuous venovenous hemodiafiltration; OHT, orthotopic heart transplantation; TPN, total parenteral nutrition
FIGURE 2
FIGURE 2
Intestinal alterations in malnutrition enteropathy. As compared to normal intestinal structure and function (A), the malnourished intestine (B) exhibits reduced absorption (villous atrophy and mucosal thinning), altered gut barrier function, and inflammation (lymphocytic infiltration, increased CD3 + T‐cell activity, and repression of IL‐10 expression by macrophages). All of these are aggravated by protein‐losing enteropathy. Modified with permission from Attia et al 5
See this image and copyright information in PMC

References

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