Nutrition in patients undergoing orthotopic liver transplant

JPEN J Parenter Enteral Nutr. Nov-Dec 1985;9(6):695-700. doi: 10.1177/0148607185009006695.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Amino Acids / blood
  • Body Height
  • Body Weight
  • Creatinine / analysis
  • Energy Metabolism
  • Humans
  • Hypersensitivity, Delayed
  • Immunity, Cellular
  • Leukocyte Count
  • Liver Diseases / complications
  • Liver Diseases / therapy
  • Liver Transplantation*
  • Middle Aged
  • Preoperative Care*
  • Protein-Energy Malnutrition / diagnosis
  • Protein-Energy Malnutrition / etiology*
  • Serum Albumin / analysis
  • Skin Tests
  • Skinfold Thickness
  • Transferrin / analysis

Substances

  • Amino Acids
  • Serum Albumin
  • Transferrin
  • Creatinine