Nutritional optimization in liver transplant patients: from the pre-transplant setting to post-transplant outcome.

IF 1.3 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2023-04-01 DOI:10.51821/86.2.11485

F M Trovato, F Artru

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Abstract

Background and study aims: malnutrition and its clinical phenotypes, sarcopenia, and frailty, are prevalent conditions that affect patients with cirrhosis awaiting liver transplantation. The link between malnutrition, sarcopenia, and frailty and a higher risk of complications or death (before and after liver transplantation) is well established. Accordingly, the optimization of nutritional status could optimize both access to liver transplantation and the outcome following the surgery. Whether optimization of nutritional status in patients awaiting LT is associated with improved outcomes after transplant is the focus of this review. This includes the use of specialized regimens such as immune-enhancing or branchedchain amino-acids-enhanced diets.

Results and conclusion: we discuss here the results of the few available studies in the field and provide an expert opinion of the obstacles that have led, so far, to an absence of benefit of such specialized regimens as compared to standard nutritional support. In the next future, combining nutritional optimization with exercise and enhanced recovery after surgery (ERAS) protocols could help optimize outcomes following liver transplantation.

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肝移植患者的营养优化:从移植前到移植后的结果。

背景和研究目的:营养不良及其临床表型、肌肉减少和虚弱是影响等待肝移植的肝硬化患者的常见疾病。营养不良、肌肉减少症和虚弱与(肝移植前后)并发症或死亡风险较高之间的联系已得到充分证实。因此，营养状况的优化可以优化肝移植的获得和手术后的预后。等待肝移植的患者营养状况的优化是否与移植后预后的改善有关是本综述的重点。这包括使用专门的方案，如免疫增强或支链氨基酸增强饮食。结果和结论:我们在此讨论该领域少数可用研究的结果，并提供专家意见，说明迄今为止导致这种专门方案与标准营养支持相比缺乏益处的障碍。在未来，将营养优化与运动和术后增强恢复(ERAS)方案相结合可以帮助优化肝移植后的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta gastro-enterologica Belgica Medicine-Gastroenterology

CiteScore

2.30

自引率

20.00%

发文量

期刊介绍： The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.