Relevance of the Nutritional Care in Patients before Liver Transplantation

Pages 92-100

Claudia Baraldi1, Nicola De Ruvo1, Rosa Maria Iemmolo1, Roberto Ballarin1, Nicola Cautero1, Giorgio Enrico Gerunda2 and Fabrizio Di Benedetto1

1Liver Transplantation Unit, Oncology and Hepato-Biliary-Pancreatic Surgery, Department of Surgeon, Medicine, Dental and Morphologic Science regarding Transplantation, Oncology and Bio-Molecular Medicine, University of Modena and Reggio Emilia, Italy; 2Division of First Surgery, Department of Surgeon, Medicine, Dental and Morphologic Science Regarding Transplantation, Oncology and Bio-Molecular Medicine, University of Modena and Reggio Emilia, Italy

http://dx.doi.org/10.12970/2308-6483.2014.02.03.3

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Abstract: Aim: To define the body composition of patients awaiting liver transplantation and analyze the effect of the nutritional counseling.

Methods: This retrospective study involved 335 patients in screening for liver transplantation. The evaluation of the nutritional status at the first access to the Center comprised: anthropometrical evaluations and Mini Nutritional Assessment. For cases that reached transplantation (N. 110), evaluated two times, the second control comprised also the Subjective Global Assessment.

Results: The Body Max Index at the first observation showed a prevalence of overweight or obesity while the Mini Nutritional Assessment and anthropometric evaluation showed that a large number of patients were at risk of malnutrition or bad nourished with a decrease of fat and/or of muscular mass. Immediately before transplantation and after a nutritional follow up with a personalized diet fat mass has been normalized in 91% and muscular mass remained stable in 56% of cases.

Conclusions: Malnutrition is largely diffused in patients undergoing liver transplantation. An evaluation by simple methods such as anthropometry and nutritional counseling is needed to ameliorate their conditions. Particular attention must be paid to counteract the decrease of fat mass and muscular mass in females.

Keywords: Body mass index, liver transplantation, mid-arm circumference, mini nutritional assessment, protein-energy malnutrition, resting energy expenditure, subjective global assessment, triceps skin fold.

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