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Review
. 2021 May 26:40:e2020149.
doi: 10.1590/1984-0462/2022/40/2020149. eCollection 2021.

METABOLIC AND NUTRITIONAL REPERCUSSIONS OF LIVER DISEASE ON CHILDREN: HOW TO MINIMIZE THEM?

[Article in English, Portuguese]
Beatriz Polisel Mazzoni  1 , Bruna Voltani Lessa  2 , Patricia Zamberlan  1
Affiliations
Review

METABOLIC AND NUTRITIONAL REPERCUSSIONS OF LIVER DISEASE ON CHILDREN: HOW TO MINIMIZE THEM?

[Article in English, Portuguese]
Beatriz Polisel Mazzoni et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: To describe the metabolic and nutritional repercussions of chronic liver disease (CLD), proposing strategies that optimize nutritional therapy in the pre- and post-liver transplantation (LT) period, in order to promote favorable clinical outcomes and adequate growth and development, respectively.

Data sources: Bibliographic search in the PubMed, Lilacs and SciELO databases of the last 12 years, in English and Portuguese; target population: children from early childhood to adolescence; keywords in Portuguese and their correlates in English: "Liver Transplant," "Biliary Atresia," "Nutrition Therapy," "Nutritional Status," and "Child"; in addition to Boolean logics "and" and "or," and the manual search of articles.

Data synthesis: Malnutrition in children with CLD is a very common condition and an important risk factor for morbidity and mortality. There is an increase in energy and protein demand, as well as difficulties in the absorption of carbohydrates, lipids and micronutrients such as fat-soluble vitamins and some minerals. An increase in the supply of energy, carbohydrates and proteins and micronutrients, especially fat-soluble vitamins, iron, zinc and calcium, is suggested, except in cases of hepatic encephalopathy (this restriction is indicated for a short period).

Conclusions: Based on metabolic changes and anthropometric and body composition monitoring, a treatment plan should be developed, following the nutritional recommendations available, in order to minimize the negative impact of malnutrition on clinical outcomes during and after LT.

Objetivo:: Revisar de forma descritiva as repercussões metabólicas e nutricionais da doença hepática crônica, propondo estratégias que aperfeiçoem a terapia nutricional nos períodos pré e pós transplante hepático (TxH), para promover desfechos clínicos favoráveis e crescimento e desenvolvimento adequados, respectivamente.

Fontes de dados:: Pesquisa bibliográfica nas bases de dados PubMed, Lilacs e SciELO dos últimos 30 anos em língua inglesa e portuguesa; população-alvo: crianças da primeira infância até a adolescência; palavras-chave em português e seus correlatos em inglês: “transplante de fígado”, “atresia biliar,” “terapia nutricional”, “estado nutricional” e “criança”; além das lógicas booleanas and e or e da busca manual de artigos.

Síntese dos dados:: A subnutrição em crianças com doença hepática crônica é uma condição muito comum e um importante fator de risco para a morbimortalidade. Ocorre aumento das demandas de energia e proteínas, bem como dificuldades na absorção de carboidratos, lipídeos e de micronutrientes como vitaminas lipossolúveis e alguns minerais. Sugere-se incremento no aporte de energia, carboidratos, proteínas e micronutrientes, sobretudo de vitaminas lipossolúveis, ferro, zinco e cálcio, exceto em casos de encefalopatia hepática (a restrição é indicada por um curto período).

Conclusões:: Com base nas alterações metabólicas, no monitoramento antropométrico e na composição corporal, um plano terapêutico deve ser elaborado, seguindo as recomendações nutricionais disponíveis, com o objetivo de minimizar o impacto negativo da subnutrição nos desfechos clínicos durante e após o transplante hepático.

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Conflict of interest statement

The authors declare there is no conflict of interests.

Figures

Figure 1
Figure 1. Flowchart of article selection.
See this image and copyright information in PMC

References

    1. Fagundes ED, Ferreira AR, Roquete ML, Penna FJ. The child with chronic liver disease: initial diagnostic approach. Rev Med Minas Gerais. 2009;19(5):28–34.
    1. Carvalho E, Ivantes CA, Bezerra JA. Extrahepatic biliary atresia: current concepts and future directions. J Pediatr. 2007;83:105–120. doi: 10.2223/jped.1608. - DOI - PubMed
    1. Muiesan P, Vergani D, Mieli-Vergani G. Liver transplantation in children. J Hepatol. 2007;46:340–348. doi: 10.1016/j.jhep.2006.11.006. - DOI - PubMed
    1. Carvalho E, Santos JL, Silveira TR, Kieling CO, Silva LR, Porta G, et al. Biliary atresia: the Brazilian experience. J Pediatr. 2010;86:473–479. doi: 10.1590/S0021-75572010000600005. - DOI - PubMed
    1. Kosola S, Lampela H, Makisalo H, Lohi J, Arola J, Jalanko H, et al. Metabolic syndrome after pediatric liver transplantation. Liver Transpl. 2014;20:1185–1192. doi: 10.1002/lt.23931. - DOI - PubMed