From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients

Abstract

Liver transplantation (LT) is a complex surgical procedure requiring thorough pre- and post-operative planning and care. The nutritional status of the patient before, during, and after LT is crucial to surgical success and long-term prognosis. This review aims to assess nutritional status assessment and management before, during, and after LT, with a focus on patients who have undergone bariatric surgery. We performed a comprehensive topic search on MEDLINE, Ovid, In-Process, Cochrane Library, EMBASE, and PubMed up to March 2023. It identifies key factors influencing the nutritional status of liver transplant patients, such as pre-existing malnutrition, the type and severity of liver disease, comorbidities, and immunosuppressive medications. The review highlights the importance of pre-operative nutritional assessment and intervention, close nutritional status monitoring, individualised nutrition care plans, and ongoing nutritional support and monitoring after LT. The review concludes by examining the effect of bariatric surgery on the nutritional status of liver transplant recipients. The review offers valuable insights into the challenges and opportunities for optimising nutritional status before, during, and after LT.

Assessment of the Risk of Malnutrition or Frailty Among Patients Undergoing Liver Transplantation: A Hospital-Based Prospective Study

“…A review has shown that administering 1.2–1.5 times the basal energy expenditure of patients before liver transplantation improves postoperative outcomes for patients undergoing liver transplantation. 15 Merli et al reported that malnutrition is a risk factor for complications and death after liver transplantation. 16 The study by Hammad et al showed that even with good liver function, preoperative nutritional changes persist long after transplantation.…”

Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients

“…Despite being physically active, the remaining seventeen subjects were outside of a structured exercise program and received indications for the Mediterranean diet. Specifically, the recommendation was about long-term nutritional support after liver transplantation [ 26 ]. In particular, it was recommended to limit fat intake and consume adequate amounts of lean protein to promote muscle development, in parallel with ensuring an adequate calorie intake to avoid protein utilization as an energy source.…”

Unlocking the Power of Late-Evening Snacks: Practical Ready-to-Prescribe Chart Menu for Patients with Cirrhosis

“…Sarcopenic obesity is a term used to define the co-presence of muscle mass depletion and strength reduction with an excess of visceral adiposity; in this case, sarcopenia can be highly overlooked due to the presence of body weight excess [25]. Obesity and sarcopenic obesity worsen the prognosis of cirrhotic patients [26] and are associated with poor transplant waitlist mortality [27,28]. Given these observations, malnutrition and sarcopenia should be promptly recognised and treated.…”