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malnutrition and liver transplant

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https://www.readbyqxmd.com/read/29072825/nutrition-and-the-transplant-candidate
#1
REVIEW
Vera C Mazurak, Puneeta Tandon, Aldo J Montano-Loza
Cirrhosis is the most common indication for liver transplantation (LT) worldwide. Malnutrition is present in at least two-thirds of patients with cirrhosis awaiting LT. It negatively impacts survival, quality of life, and the ability to respond to stressors, such as infection and surgery. Muscle wasting or sarcopenia is the most objective feature of chronic protein malnutrition in cirrhosis, and this condition is associated with increased morbidity and mortality before and after LT. In addition to its objectivity, muscularity assessment with cross-sectional imaging studies is a useful marker of nutritional status in LT candidates, as sarcopenia reflects a chronic decline in the general physical condition, rather than acute severity of the liver disease...
November 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29035331/nutritional-needs-and-support-for-children-with-chronic-liver-disease
#2
REVIEW
Christine H Yang, Brandon J Perumpail, Eric R Yoo, Aijaz Ahmed, John A Kerner
Malnutrition has become a dangerously common problem in children with chronic liver disease, negatively impacting neurocognitive development and growth. Furthermore, many children with chronic liver disease will eventually require liver transplantation. Thus, this association between malnourishment and chronic liver disease in children becomes increasingly alarming as malnutrition is a predictor of poorer outcomes in liver transplantation and is often associated with increased morbidity and mortality. Malnutrition requires aggressive and appropriate management to correct nutritional deficiencies...
October 16, 2017: Nutrients
https://www.readbyqxmd.com/read/29035319/nutritional-therapy-in-liver-transplantation
#3
REVIEW
Ahmed Hammad, Toshimi Kaido, Vusal Aliyev, Claudia Mandato, Shinji Uemoto
Protein-energy malnourishment is commonly encountered in patients with end-stage liver disease who undergo liver transplantation. Malnutrition may further increase morbidity, mortality and costs in the post-transplantation setting. The importance of carefully assessing the nutritional status during the work-up of patients who are candidates for liver replacement is widely recognized. The metabolic abnormalities induced by liver failure render the conventional assessment of nutritional status to be challenging...
October 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28930104/liver-transplantation-in-the-obese-cirrhotic-patient
#4
REVIEW
Erin K Spengler, Jacqueline G O'Leary, Helen S Te, Shari Rogal, Anjana A Pillai, Abdullah Al-Osaimi, Archita Desai, James N Fleming, Daniel Ganger, Anil Seetharam, Georgios Tsoulfas, Martin Montenovo, Jennifer C Lai
Despite the rapidly increasing prevalence of obesity in the transplant population, the optimal management of obese liver transplant candidates remains undefined. Setting strict body mass index cutoffs for transplant candidacy remains controversial, with limited data to guide this practice. Body mass index is an imperfect measure of surgical risk in this population, partly due to volume overload and variable visceral adiposity. Weight loss before transplantation may be beneficial, but it remains important to avoid protein calorie malnutrition and sarcopenia...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28856568/nutritional-status-using-subjective-global-assessment-independently-predicts-outcome-of-patients-waiting-for-living-donor-liver-transplant
#5
Sanjay Kumar Yadav, Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Sanjay Goja, Amit Rastogi, Prashant Bhangui, A S Soin
BACKGROUND: Malnutrition is an important risk factor for adverse outcomes in patients awaiting liver transplant. Living donor liver transplant, being an elective procedure, allows nutritional rehabilitation and optimization of these patients before transplant. AIM: This paper aimed to evaluate the outcome of end-stage liver disease (ESLD) patients with various degrees of malnutrition waiting for living donor liver transplant. METHODS: Nutritional status was assessed using subjective global assessment (SGA) in patients who were evaluated for a liver transplant at our center from January 2015 to September 2015...
July 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#6
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28699603/infants-with-extrahepatic-biliary-atresia-effect-of-follow-up-on-the-survival-rate-at-ege-university-medical-school-transplantation-center
#7
Miray Karakoyun, Maşallah Baran, Caner Turan, Murat Kılıç, Orkan Ergun, Sema Aydoğdu
BACKGROUND/AIMS: Biliary atresia (BA) is the main cause of neonatal cholestasis and the primary reason for infant liver transplants worldwide. It is an obliterative cholangiopathy observed only in children and caused by progressive inflammation and fibrosis of the bile duct. We collaborated with a liver transplantation center to investigate the effects of follow-up in patients with BA. MATERIALS AND METHODS: Medical records of 99 patients who were diagnosed with BA and monitored at our center from 1990 to 2002 (27 patients) and from 2003 to 2015 (72 patients) were analyzed retrospectively...
July 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28604513/severe-sarcopenia-and-increased-fat-stores-in-pediatric-patients-with-liver-kidney-or-intestine-failure
#8
Richard S Mangus, Weston J Bush, Christina Miller, Chandrashekhar A Kubal
OBJECTIVES: Malnutrition and wasting predict clinical outcomes in children with severe chronic illness. Objectively calculated malnutrition in children with end-stage organ failure has not been well studied. This analysis compares children with kidney, liver or intestine failure to healthy controls to quantitate the disparity in muscle and fat stores. METHODS: Children younger than 19 years with end-stage liver, kidney, or intestine failure and with pretransplant computed tomography (CT) imaging were selected from the transplant database...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28602070/a-prognostic-evaluation-and-management-of-alcoholic-hepatitis
#9
Ramesh Rana, Sheng-Lan Wang, Jing Li, Lu Xia, Mei-Yi Song, Chang-Qing Yang
Alcoholic hepatitis is an acute and severe form of alcoholic liver disease associated with high morbidity and mortality of 30-50% worldwide, severity ranging from asymptomatic derangement of liver biochemistries to fulminant liver failure or death. Rapidly progressing jaundice and coagulopathy in prolonged excessive alcohol abusers with or without fever, malnutrition, and tender liver are the clinical hallmarks. The prognostic models (MELD, MDF, ABIC, GAHS, Lille's score) not only predict the short term mortality, but also guide the clinicians to choose appropriate specific therapy (corticosteroid or pentoxifylline) and as a stopping rule if there is no significant benefits of it...
June 9, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28549896/concordance-among-methods-of-nutritional-assessment-in-patients-included-on-the-waiting-list-for-liver-transplantation
#10
María Teresa García-Rodríguez, Beatriz López-Calviño, María Del Carmen Piñón-Villar, Alejandra Otero-Ferreiro, Francisco Suárez-López, Manuel Gómez-Gutiérrez, Sonia Pértega-Díaz, María Teresa Seoane-Pillado, Salvador Pita-Fernández
BACKGROUND: The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. METHODS: Patients on the waiting list for liver transplantation (n = 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child-Pugh Scale...
October 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28457405/diaphragm-muscle-surface-electromyography-in-patients-submitted-to-liver-transplant-and-eligible-for-extubation
#11
R P Duarte, A C Sentanin, A M O da Silva, R M Tonella, G L Duarte, L S R Ratti, I F S F Boin
INTRODUCTION: Liver disease induces many organic and metabolic changes, leading to malnutrition and weight and muscular function loss. Surface electromyography is an easily applicable, noninvasive study, through which the magnitudes of the peaks on the charts depict voluntary muscle activity. AIM: To evaluate the diaphragmatic surface electromyography of postoperative liver transplantation subjects. METHODS: Subjects were patients who underwent liver transplantation and extubation in the Clinical Hospital of State University of Campinas...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28422306/development-of-a-novel-frailty-index-to-predict-mortality-in-patients-with-end-stage-liver-disease
#12
Jennifer C Lai, Kenneth E Covinsky, Jennifer L Dodge, W John Boscardin, Dorry L Segev, John P Roberts, Sandy Feng
Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified by the Model for End-Stage Liver Disease (MELD) Sodium (MELDNa) score. We aimed to develop a frailty index to capture these extrahepatic complications of cirrhosis and enhance mortality prediction in patients with cirrhosis. Consecutive outpatients listed for liver transplantation at a single transplant center without MELD exceptions were assessed with candidate frailty measures...
August 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28361750/nutritional-status-and-the-performance-of-multiple-bedside-tools-for-nutrition-assessment-among-patients-waiting-for-liver-transplantation-a-canadian-experience
#13
Kaleb J Marr, Abdel-Aziz Shaheen, Louisa Lam, Melanie Stapleton, Kelly Burak, Maitreyi Raman
BACKGROUND: Malnutrition is an important predictor of morbidity and mortality among cirrhotic patients. Our objectives were to assess protein-calorie malnutrition (PCM) in cirrhotic pre-liver transplant patients and to study the correlation between subjective global assessment (SGA) and other objective measures of malnutrition. METHODS: We recruited pre-liver transplant adult patients at our center between October 2012 and Oct 2015. Nutrition status was assessed via SGA...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28340841/liver-transplantation-for-polycystic-liver-disease-due-to-huge-liver-with-related-complications-a-case-report
#14
S Acar, G Gencdal, M Tokac, E Eren, U Alkara, G Tellioglu, A Dinckan, M Akyildiz
Polycystic liver disease is characterized by multiple cystic lesions on the liver. It is an uncommon autosomal dominant disease. The cysts' diameters range from 20 to 30 cm to small microscopic nodules. Generally, more than half of the liver parenchyma is covered. The mass effect of the liver created by the large cysts can cause life-threatening symptoms such as weight loss, reduction of oral intake, and malnutrition. Liver transplantation is the best treatment option in symptomatic patients. We present a patient who had polycystic liver and kidney disease, and we performed liver transplantation because of his life-threatening symptoms...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28256569/aggressive-non-alcoholic-steatohepatitis-following-rapid-weight-loss-and-or-malnutrition
#15
Jia-Huei Tsai, Linda D Ferrell, Vivian Tan, Matthew M Yeh, Monika Sarkar, Ryan M Gill
While non-alcoholic steatohepatitis is a slowly progressive disease, patients may rarely present in acute liver failure. We describe six patients who developed severe hepatic dysfunction following rapid weight loss or malnutrition. Rapid weight loss (18 to 91 kg) occurred after Roux-en-Y gastric bypass in four patients and starvation-like dieting or hypoalbuminemia was noted in two patients. Four patients either died or received an urgent liver transplant. Pathologic findings were characterized by advanced alcoholic steatohepatitis-like features, including extensive/circumferential centrizonal pericellular fibrosis, central scar with perivenular sclerosis/veno-occlusion with superimposed hepatocellular dropout, abundant/prominent hepatocellular balloons, and numerous Mallory-Denk bodies, but there was no history of excess alcohol consumption...
June 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28226199/mortality-risk-factors-among-patients-with-cirrhosis-and-a-low-model-for-end-stage-liver-disease-sodium-score-%C3%A2-15-an-analysis-of-liver-transplant-allocation-policy-using-aggregated-electronic-health-record-data
#16
K Atiemo, A Skaro, H Maddur, L Zhao, S Montag, L VanWagner, S Goel, A Kho, B Ho, R Kang, J L Holl, M M Abecassis, J Levitsy, D P Ladner
Although the Model for End-Stage Liver Disease sodium (MELD Na) score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7834 adult patients with cirrhosis, we determined whether the cause of cirrhosis or cirrhosis complications was associated with an increased risk of death among patients with a MELD Na score ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT)...
February 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28149980/perifollicular-petechiae-and-easy-bruising
#17
Krishna Aj Mutgi, Grant Ghahramani, Karolyn Wanat, Heather Ciliberto
This patient was a liver transplant recipient and had a history of malnutrition. One tell-tale sign on the physical exam, however, left no doubt as to the diagnosis.
December 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/27957786/impaired-intention-to-treat-survival-after-listing-for-liver-transplantation-in-children-with-biliary-atresia-compared-to-other-chronic-liver-diseases-20%C3%A2-years-experience-from-the-nordic-countries
#18
S Malenicka, B-G Ericzon, M H Jørgensen, H Isoniemi, T H Karlsen, M Krantz, V Naeser, M Olausson, A Rasmussen, K Rönnholm, T Sanengen, T Scholz, B Fischler, A Nemeth
Biliary atresia (BA) is the most common indication for LT in children. We investigated whether this diagnosis per se, compared to other chronic liver diseases (OCLD), had an influence on patient survival. Data from 421 Scandinavian children, 194 with BA and 227 with OCLD, listed for LT between 1990 and 2010 were analyzed. The intention-to-treat survival and influencing risk factors were studied. Patients with BA had higher risk of death after listing than patients with OCLD. The youngest (<1 year) and smallest (<10 kg) children with the highest bilirubin (>510 μmol/L), highest INR (>1...
March 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/27709718/body-composition-assessed-by-dual-energy-x-ray-absorptiometry-predicts-early-infectious-complications-after-liver-transplantation
#19
C Lindqvist, A Majeed, S Wahlin
BACKGROUND: It is challenging to identify malnutrition, which is a risk factor for poor outcome in patients with liver cirrhosis. In the present study, we aimed to investigate the prevalence of malnutrition among patients listed for liver transplantation, as assessed by different methods, and also to relate dual-energy X-ray absorptiometry (DXA) to short-term post-transplant outcomes. METHODS: In this retrospective cohort study, we reviewed the medical records of 106 patients who underwent liver transplantation in 2009-2012...
October 6, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/27650268/biliary-atresia-indications-and-timing-of-liver-transplantation-and-optimization-of-pretransplant-care
#20
REVIEW
Shikha S Sundaram, Cara L Mack, Amy G Feldman, Ronald J Sokol
Biliary atresia (BA) is a progressive, fibro-obliterative disorder of the intrahepatic and extrahepatic bile ducts in infancy. The majority of affected children will eventually develop end-stage liver disease and require liver transplantation (LT). Indications for LT in BA include failed Kasai portoenterostomy, significant and recalcitrant malnutrition, recurrent cholangitis, and the progressive manifestations of portal hypertension. Extrahepatic complications of this disease, such as hepatopulmonary syndrome and portopulmonary hypertension, are also indications for LT...
January 2017: Liver Transplantation
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