Korean J Transplant.  2020 Mar;34(1):38-46. 10.4285/kjt.2020.34.1.38.

Poor preoperative enteral nutrition would be a risk factor for readmission due to infection after liver transplantation

Affiliations
  • 1Department of Surgery, Kosin University College of Medicine, Busan, Korea
  • 2Nutritional Support Team, Kosin University Gospel Hospital, Busan, Korea
  • 3Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
  • 4Department of Neurosurgery, Kosin University College of Medicine, Busan, Korea

Abstract

Background
Most patients who undergo liver transplantation (LT) have advanced cirrhosis and poor nutritional status. The aim of this study was to investigate the effect of enteral nutrition (EN) on the clinical outcomes after LT.
Methods
From 2015 to 2019, the medical records of recipient of LT at Kosin University Gospel Hospital were retrospectively reviewed.
Results
Thirty-seven patients underwent LT. Nineteen patients underwent living donor liver transplantation (LDLT) and 18 patients underwent deceased donor liver transplantation (DDLT). One LDLT patient was excluded because transplantation was done within 1 month. Five DDLT patients were excluded either because they died within 1 month (n=4) or received transplantation within 1 month. (n=1). Therefore, 31 patients were analyzed. Psoas-muscle index (P=0.715) and serum albumin (P=0.111) were not statistically different between the LDLT and DDLT groups. Four patients (4/31) were readmitted because of infection. One LDLT patient was diagnosed with genitourinary infection. The three DDLT patients were diagnosed with pulmonary tuberculosis (n=1), diverticulitis (n=1), and sepsis (n=1). Readmission caused by infection was not statistically different between LDLD and DDLT patients (P=0.284). Preoperative EN <25% of the recommended amount (P=0.016) was significantly associated with readmission related to infection. In multivariate analyses, preoperative EN <25% was an independent risk factor for readmission due to infection after LT regardless of psoas-muscle index, baseline Model for End-Stage Liver Disease score, or LT type.
Conclusions
Preoperative poor EN is significantly associated with readmission risk due to infection within 3 months of LT.

Keyword

Liver transplantation; Enteral nutrition; Infection; Psoas-muscle index
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