Evaluation of Nutritional Status as a Prognostic Indicator for the Outcome in Liver Transplant Recipients | ||||
| The Medical Journal of Cairo University | ||||
| Article 37, Volume 88, June, June 2020, Page 1287-1295 PDF (384.78 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2020.110931 | ||||
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| Authors | ||||
| MOHAMED A.M. ALI, M.D.; RANDA A. SHOUKRY, M.D.; DALIA F. EMAM, M.D.; EMAN I. EL-DESOKI MAHMOUD, M.D.; MOHAMED I.I. AKP EL-BAB, M.Sc. | ||||
| The Department of Anesthesiology, General Intensive Care Medicine & Pain Management, Faculty of Medicine, Ain Shams University* and Fellow of General Intensive Care, National Hepatology & Tropical Medicine Research Institute, Cairo** | ||||
| Abstract | ||||
| Abstract Background: Mal-nutrition is a common complication of the end-stage liver disease and associated with increased morbidity and mortality rates. Numerous studies have proved that pre-operative mal-nutrition is related to higher risk of surgical morbidities and mortalities in general surgical patients. Mal-nourished patients tend to have high rates of infectious complications, prolonged intensive care unit (ICU) stay, hospital stay and increased mortality. Aim of Study: To determine the impact of nutritional status pre-liver transplant on recipients' course and the outcome post-transplant. Patients and Methods: Pre-operative nutritional assessment with Subjective global assessment (SGA) was done retrospec-tively for 52 patients, categorized as well-nourished, mild, moderate and severe mal-nourished and followed for post-operative course. Results: The causes of transplant were mainly decompen-sated chronic liver disease (46.2%), hepato-cellular carcinoma (32.7%) and auto-immune with HCC (11.5%). As a result of all these complications, the ICU stay, hospital stay, 28 day mortality were less in well-nourished patients in comparison to the mal-nourished one. Conclusion: The nutritional status pre-liver transplant is an important factor which can affect the outcome of the liver transplant patients. The mal-nourished patients showed a higher incidence of post-operative sepsis, a higher post-operative bilirubin levels, a more need for post-operative nutritional intervention, a higher incidence of need of re-intubation for mechanical ventilation, a higher incidence of post-operative renal impairment and neurological complica-tions. As a result of all these complications, the ICU stay, hospital stay, 28 day mortality were less in well-nourished patients in comparison to the mal-nourished one. So, pre-operative assessment and optimizing the nutritional status is an essential step before proceeding for surgery. | ||||
| Keywords | ||||
| Malnutrition; Mal-nourished; Well-nourished; Liver transplantation; SGA; HCC; Decom-pansated chronic liver disease; TPN; Demo-graphic data; BMI; Post-operative; Nutritional intervention; Stay; Mortality; Liver functions; Sepsis; Renal | ||||
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