Characteristics of Nutritional Status and the Effect of Pre-transplant Branched-chain Amino Acid Administration in Patients Undergoing Living Donor Liver Transplantation
Received Date: Feb 15, 2016 / Accepted Date: Apr 15, 2016 / Published Date: Apr 22, 2016
Background: Protein-energy malnutrition is common in patients with end-stage liver disease undergoing liver transplantation. We examined the characteristics of nutritional status and impact of pre-admission branched-chainamino- acids treatment on skeletal muscle mass, nutritional/metabolic parameters and on post-transplant outcomes.
Methodology: Preoperative skeletal muscle mass and nutritional/metabolic parameter levels were compared in 129 patients undergoing adult-to-adult living donor liver transplantation whether received branched-chain-aminoacids treatment before admission or not. We examined relationships among these parameters, and risk factors for post-transplant bacteremia and early mortality after LT focusing on nutritional parameters.
Results: Pre-albumin and branched-chain-amino-acids-to-tyrosine ratio were significantly higher while tyrosine was lower in branched-chain-amino-acids-pre-supplemented than non-pre-supplemented group, while skeletal muscle mass, total lymphocyte count, zinc, branched-chain-amino-acids and ammonia levels were not significantly different. Skeletal muscle mass positively correlated with tyrosine (r=0.437, P<0.001) and branched-chain-aminoacids (r=0.282, P=0.001) and negatively with branched-chain-amino-acids-to-tyrosine-ratio (r=-0.259, P=0.003). Multivariate predictors of post-transplant bacteremia were: Child-Pugh class C (P=0.012), low preoperative total lymphocyte count (P=0.027), operative blood loss ≥ 10 L (P=0.039) and absence of pre-admission branched-chainamino- acids treatment (P=0.040). Nutritional/metabolic parameters and pre-admission branched-chain-amino-acids treatment were not crucial for post-transplant early mortality.
Conclusion: Pre-admission branched-chain-amino-acid therapy could ameliorate preoperative amino acid imbalance and the incidence of post-transplant bacteremia.
Keywords: Branched-chain amino acids; Bioelectrical impedance analysis; Skeletal muscle mass; Sarcopenia; Zinc
Citation: Hammad A, Kaido T, Yagi S, Okajima H, Uemoto S (2016) Characteristics of Nutritional Status and the Effect of Pre-Transplant Branched-Chain Amino Acid Administration in Patients Undergoing Living Donor Liver Transplantation. J Clin Exp Transplant 1: 101. Doi: 10.4172/2475-7640.1000101
Copyright: © 2016 Hammad A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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