Nutritional Intake after Liver Transplant: Systematic Review and Meta-Analysis

Abstract

Cardiovascular disease and its concurrent risk factors are prevalent after liver transplant (LT). Most of these risk factors are modifiable by diet. We aimed to synthesise the literature reporting the nutritional intake of liver transplant recipients (LTR) and the potential determinants of intake. We performed a systematic review and meta-analyses of studies published up until July 2021 reporting the nutritional intake of LTR. The pooled daily mean intakes were recorded as 1998 (95% CI 1889, 2108) kcal, 17 (17, 18)% energy from protein, 49 (48, 51)% energy from carbohydrates, 34 (33, 35)% energy from total fat, 10 (7, 13)% energy from saturated fat, and 20 (18, 21) g of fibre. The average fruit and vegetable intake ranged from 105 to 418 g/day. The length of time post-LT and the age and sex of the cohorts, as well as the continent and year of publication of each study, were sources of heterogeneity. Nine studies investigated the potential determinants of intake, time post-LT, gender and immunosuppression medication, with inconclusive results. Energy and protein requirements were not met in the first month post-transplant. After this point, energy intake was significantly higher and remained stable over time, with a high fat intake and low intake of fibre, fruits and vegetables. This suggests that LTR consume a high-energy, low-quality diet in the long term and do not adhere to the dietary guidelines for cardiovascular disease prevention.

Nutrition and continuous nursing intervention following radical resection of esophageal cancer in a patient after liver transplantation: a case report

“…Following radical resection of esophageal cancer, patients often encounter difficulties in dietary intake, such as swallowing difficulties and reduced food consumption ( 6 , 7 ). To address this, a thorough nutritional assessment is crucial to identify malnutrition risks or early signs of malnutrition and implement appropriate intervention measures ( 8 ).…”

“…For patients after liver transplantation, it is important to maintain appropriate food safety measures to ensure the patients remain healthy as an immune-compromised individuals. Nutrition recommendations are customized for individual patients with general guidance both pretransplant and posttransplant, with general guidance ( 6 ). The side-effects of immunosuppressive medication can be very hard on the body ( 7 ).…”

Abdominal Organ Transplantation: Noteworthy Literature in 2023

“…Practitioners with knowledge of dietary behaviors and the potential determinants of diet after LT may be able to implement evidence-based behavioral interventions and dietary guidelines that aim to improve health outcomes after LT. Spillman et al performed a systematic review and metaanalysis of studies published until July 2021 reporting the nutritional intake of LT recipients. 51 This review included 21 studies published between 2001 and 2021. Of them, 2 were RCTs, 13 were prospective cohort studies, and 6 were cross-sectional.…”

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

“…Cardiovascular risk factors after a liver transplant are also modifiable by eating habits. These patients consume a high-energy, low-quality diet in the long term [ 12 ], and they do not adhere to the dietary guidelines for cardiovascular disease prevention [ 13 ]. Studies initially focused on controlling caloric, fat, and protein intake, also using supplements [ 9 , 14 ].…”