Preoperative Evaluation, Preparation, and Timing of Orthotopic Liver Transplantation in the Child

Nutritional status and intestinal iron absorption in children with chronic hepatic disease with and without cholestasis

“…Nutritional deficiencies are common among children with chronic liver disease, especially when the process is cholestatic and has onset before 6 months. 1 Severe proteinenergy malnutrition affects approximately 60% of children with chronic liver disease, [2][3][4][5] being secondary to the interaction of multiple factors, including reduced nutritional intake, intestinal malabsorption and increased nutrient requirements due to increased energy expenditure. 1,6,7 Despite the knowledge that an adequate nutritional status contributes towards successful liver transplantation and lower rates of postoperative complications, 5,[8][9][10][11][12] studies performed during transplant pre-op show that a large proportion of patients with chronic liver disease exhibit inadequate nutrient intake and protein-energy malnutrition.…”

Nutritional status and intestinal iron absorption in children with chronic hepatic disease with and without cholestasis

“…A desnutrição energético-protéica grave afeta aproximadamente 60% das crianças com doença hepática crô-nica [2][3][4][5] , sendo secundária à interação de múltiplos fatores, entre os quais, diminuição da ingestão alimentar, má absorção intestinal e aumento das necessidades de nutrientes em função de maior gasto energético 1,6,7 . Apesar do conhecimento de que o estado nutricional adequado contribui para o sucesso, sobrevida e menores taxas de complicações após o transplante hepático 5,[8][9][10][11][12] , estudos realizados no pré-operatório do transplante mostram que grande parte dos pacientes com doença hepática crônica apresenta ingestão de nutrientes insuficiente e desnutrição energéti-co-protéica 6,12 .…”

Nutritional Aspects of Chronic Liver Disease and Liver Transplantation In Children

“…Optimal nutritional therapy involves maintaining high caloric and protein intake while preventing specific nutrient deficiencies. Children with end‐stage liver disease require 130% to 150% of the recommended dietary allowances of energy for their ideal body weight and 2.5 to 3.0 g/kg of protein (10). This amount of protein can blunt the catabolic state typical in these children and improve growth rate.…”