Journal
NUTRITION REVIEWS
Volume 66, Issue 1, Pages 47-54Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1753-4887.2007.00005.x
Keywords
branched-chain amino acids; liver transplantation; nutritional therapy; protein malnutrition
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Patients with end-stage liver disease often reveal significant protein-energy malnutrition, which may deteriorate after listing for transplantation. Since malnutrition affects post-transplant survival, precise assessment must be an integral part of pre- and post-surgical management. While there is wide agreement that aggressive treatment of nutritional deficiencies is required, strong scientific evidence supporting nutritional therapy is sparse. In practice, oral nutritional supplements are preferred over parenteral nutrition, but enteral tube feeding may be necessary to maintain adequate calorie intake. Protein restriction should be avoided and administration of branched-chain amino acids may help yield a sufficient protein supply. Specific problems such as micronutrient deficiency, fluid balance, cholestasis, encephalopathy, and comorbid conditions need attention in order to optimize patient outcome. (c) 2008 International Life Sciences Institute.
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