Association between artificial nutrition in brain dead donors and early allograft function in liver transplant recipients: an observational study

Abstract

Background:The role of nutrition in donor after brain deaths (DBDs) has yet to be adequately discussed. The primary aim of this study was to investigate whether the nutritional intake in the 48 h before organ retrieval may play a role on the graft functional recovery assessed with Model for Early Allograft Function (MEAF) Score.Methods: Single-center retrospective study evaluating all liver transplants performed at the University Hospital of Udine from January 2010 to August 2020. Patients receiving grafts from DBD donors fed with artificial enteral nutrition in the 48 h prior to organ procurement (EN-group) or who did not (No-EN-group). Caloric debt was calculated using the difference between the calculated caloric needs and the effective calories delivered through enteral nutrition.Results: Livers from EN-group presented a lower mean MEAF score compared to the no-EN-group: 3.39 ± 1.46 versus 4.15 ± 1.51, respectively (p = .04). A positive correlation between caloric debt and the MEAF score was found within the overall population (r = .227, p = .043) as well as in EN-group (r = .306, p = .049).Conclusions: Donor's nutritional intake in the final 48 h before organ procurement correlates with MEAF score, and nutrition probably plays a positive role on the functional recovery of the graft. Large future randomized controlled trials are needed to confirm this preliminary results.

Better liver transplant outcomes by donor interventions?

“…Providing nutritional support to deceased donors has not been well studied. A recent retrospective study comparing DBD donors supported or not with enteral nutrition (EN) described better graft function among EN livers, though EN donors had been in intensive care longer (see subsequent section “Duration of brain death”) and had better renal function at time of donation [31 ▪ ]. Another small RCT, on the other hand, did not detect relevant differences in organ-specific outcomes between fed and fasting DBD donors [32].…”