Evaluation of Nutritional Status as a Prognostic Indicator for the Outcome in Liver Transplant Recipients
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- Category: Vol. 88, June 2020
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Evaluation of Nutritional Status as a Prognostic Indicator for the Outcome in Liver Transplant Recipients, MOHAMED A.M. ALI, RANDA A. SHOUKRY, DALIA F. EMAM, EMAN I. EL-DESOKI MAHMOUD and MOHAMED I.I. AKP EL-BAB
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.