Nutritional Optimization of Patients Undergoing Liver Transplantation

AbstractPurpose of ReviewMalnutrition is common in patients with cirrhosis and is widely common in those with compensated cirrhosis and remains a significant risk factor for mortality even in those with lower model of end-stage liver disease (MELD) scores. There exists an intricate interplay between frailty, malnutrition, and loss of muscle mass, making nutritional intervention an important part of caring for patients undergoing liver transplant evaluation. This manuscript will review the approach to caring for patients before, during, and after liver transplantation.Recent FindingsMultiple studies have demonstrated that malnutrition, sarcopenia, and frailty in cirrhosis are associated with higher rates of cirrhosis-related complications, hospitalizations, worsened quality of life, worse postsurgical outcomes after liver transplantation, and increased mortality. Malnutrition is associated with more frequent episodes of hepatic encephalopathy (HE), ascites, and increased susceptibility to infections prior to liver transplant. It is in the interest of patients to be screened for and treated for malnutrition.SummaryNutritional screening is recommended in all patients with cirrhosis. In this chapter, we will review the multidisciplinary approach for nutritional optimization in pre- and post-liver transplant setting.
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research