Importance of Nutritional Evaluation in Transplant Patients Awaiting Lung Transplantation (original) (raw)
Related papers
Clinical Nutrition Experimental, 2019
Background & aims: Lung transplantation represents a key treatment option for patients with chronic respiratory failure. Nutritional status and management appear to have a major impact on post-transplant outcome. The recommendations of the French-Speaking Society of Clinical Nutrition and Metabolism (SFNEP) are reference guidelines for managing undernutrition. The aims of this study were to provide an insight into the pre-and post-lung transplant nutritional status and nutritional management of these patients. Methods: This was a single-center, retrospective, comparative, observational study, which was focused on patients who were the most at risk for undernutrition or worsening of preexisting undernutrition. We included patients with BMIs of less than 25 kg/m 2 at pre-transplant evaluation. We collected general and nutritional data during the follow-up of our patients before and after transplantation.
Journal of Heart and Lung Transplantation, 2001
It is well documented that malnourished and/or obese surgical patients have increased morbidity and mortality post-operatively. Only a few studies investigating the effect of nutritional status on mortality are available pertaining to the transplant population. Since limited data are available on the nutritional status and its effects on mortality in the lung transplant population, we sought to ascertain whether there is an association between mortality and preoperative nutritional status.
Nutritional status, ICU duration and ICU mortality in lung transplant recipients
Intensive care medicine, 1996
Objective." To determine the relation of malnutrition and underlying diagnosis to the length of stay in the Intensive Care Unit (ICU) and to mortality after lung transplantation (LTX). Design: Retrospective ICU chart review. Setting." Cardiothoracic ICU in a University hospital. Patients: Fifty-one consecutive patients who suffered from end-stage lung disease from April 1992 to January 1994. Interventions." None. Measurements and results." The median time spent in the ICU was 5 days (range, 2 123 days). Patients with an underlying diagnosis of obstructive lung disease had significantly shorter ICU stays (median 4 days; range, 2 28 days) than those with restrictive lung disease (median 7 days; range, 2-123 days) (p = 0.005) or pulmonary hypertension (median 10 days; range, 2-38 days) (p = 0.041). Significant differences in ICU duration were ob-(BMI below the 25th percentile) is a risk factor for ICU mortality in cases of patients who stay for 5 days or longer in the ICU.
HepatoBiliary Surgery and Nutrition, 2016
Background: Malnutrition is highly prevalent in patients undergoing liver transplantation and has been associated to various clinical variables and outcome of the surgery. Methods: We recruited 54 adult patients undergoing living donor liver transplant (LT) as study sample. Nutrition assessment was performed by body mass index (BMI), BMI for ascites, albumin, subjective global assessment (SGA) and anthropometry [mid upper arm circumference (MUAC), mid arm muscle circumference (MAMC), and triceps skin-fold (TSF)], Hand Grip strength, and phase angle of the body. Prevalence and comparison of malnutrition was performed with various clinical variables: aetiology, Child Turcotte Pugh scores and model for end stage liver disease (ESLD) grades, degree of ascites, blood product usage, blood loss during the surgery, mortality, days [intensive care unit (ICU), Ventilator and Hospital], and Bio-impedance analysis [weight, fat mass, fat free mass (FFM), muscle mass and body fat%]. Results: Assessment of nutrition status represents a major challenge because of complications like fluid retention, hypoalbuminemia and hypoproteinemia. Different nutrition assessment tools show great disparity in the level of malnutrition among ESLD patients. In the present study recipient nutrition status evaluation by different nutrition assessment tools used showed malnutrition ranging from 3.7% to 100%. BMI and anthropometric measurements showed lower prevalence of malnutrition than phase angle and SGA whereas hand grip strength showed 100% malnutrition. Agreement among nutrition assessment methods showed moderate agreement (κ=0.444) of SGA with phase angle of the body. Malnutrition by different assessment tools was significantly associated to various clinical variables except MELD and days (ICU, Ventilator and Hospital). SGA was significantly (P<0.05) associated to majority of the clinical variables like aetiology, child Turcotte Pugh grades, degree of ascites, blood product usage , blood loss during the surgery, BIA (fat mass, FFM, muscle mass and body fat%). Conclusions: The different nutrition assessment tools showed great variability of results. SGA showed moderate agreement with phase angle of the body and was associated with various clinical and prognostic variables of liver transplantation.
Clinical and nutritional evaluation indicators of patients on waiting list for liver transplantation
2019
Objective: Comparing different methods of clinical and anthropometric assessment of pre-liver transplant patients. Methods: This was a cross-sectional study with quantitative approach. We analyzed data from the medical records of pre-transplant patients older than 18 who received care at a Nutrition outpatient clinic of a Liver Transplant Center in Fortaleza-CE. We collected data regarding patient identification, clinical diagnosis, nutritional assessment and diagnosis. This study was approved by the Ethics Committee in Research of Walter Cantidio University Hospital of the Federal University of Ceara. Data were analyzed in the statistical program SPSS TM version 17.0 Results: The sample consisted of 71 patients, with 46 men (64.8%) and 25 women (35.2%), with a mean age of 53.7 years. The average BMI was 27.2 kg/m2; most women were healthy (60.0%) and most men were with excess of body weight (69.0%). As for the nutritional diagnosis according to the percentage of adequacy of the mid...
Nutritional assessment and management in liver transplantation
Revista Espanola de Enfermedades …, 2006
Patients eligible for solid organ transplantation are functionally end-stage regarding the organ to be transplanted. Being chronic patients, they usually display malnutrition to some extent (1). Weight loss and other malnutrition signs are considered predictive factors for poor prognosis regarding the outcome of surgical patients, including patients undergoing a solid-organ transplant (2,3). The presence of malnutrition is associated with increased morbidity and mortality, and higher healthcare costs (4). Major malnutrition causes in patients with advanced liver disease include inadequate dietary intake-from anorexia, from drugs and therapy-related dietary changes, or from disease complications-and main nutrient-related metabolic changes (5). Regardless of the underlying disease, a diagnosis of malnutrition is established by a combination of various methods: medical record, anthropometric measurements, biochemical parameters, and body composition. As de Luis et al. suggest in this issue of REED (6), end-stage liver disease itself may greatly modify many of these indices. Ideally, accurate body composition techniques such as K measurement 40 or deuterium concentration should be used. Unfortunately, such techniques require complex equipments available only in a few centers. However, such technical limitations do not justify the omission of nutritional assessments in patients eligible for liver transplantation. Nutritional screening tests are a good tool for the initial assessment of a patient's nutritional status, even when they are not specifically indicated for advanced chronic liver disease (7,8). Anthropometric measurements may also be useful, except when water and salt retention are significant (9). In contrast, plasma concentration measurements regarding some proteins are not so useful in these patients. DXA (dual-energy X-ray absorptiometry) is a method for body composition analysis based on the measurement of a body property, rather than a body component. Many hospitals have this instrument to assess bone mineral density, and it also provides sound information on other body components, including fat mass (10). While some experiences with this method have been reported in patients with cirrhosis (11), its accuracy for patients with water and salt decompensation remains to be definitely established. On the other hand, the accuracy of a bioimpedance analysis depends on the applicability of the regression equation relating current resistance through the body to body composition parameters. This method may scarcely sensitive for the detection of brisk water volume changes, particularly in the abdomen. Despite this, some groups advocate for its usefulness in the assessment of patients with advanced liver disease (12). De Luis et al. have assessed 31 candidates to liver transplantation using nutritional screening tests, anthropometric and biochemical measures, and bioimpedance Nutritional assessment and management in liver transplantation
Journal of Epidemiology, 2017
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 ¼ 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the ChildePugh Scale. Nutritional state was studied using the Controlling Nutritional Status (CONUT), the Spanish Society of Parenteral and Enteral Nutrition (SENPE) criteria, the Nutritional Risk Index (NRI), the Prognostic Nutritional Index (PNI-O), and the Subjective Global Assessment (SGA). Agreement was determined using the Kappa index. Area under receiver operator characteristic curves (AUCs), the Youden index (J), and likelihood ratios were computed. Results: Malnutrition varied depending on the method of evaluation. The highest value was detected using the CONUT (90.9%) and the lowest using the SGA (50.9%). The pairwise agreement among the methods ranged from K ¼ 0.041 to K ¼ 0.826, with an overall agreement of each criteria with the remaining methods between K ¼ 0.093 and K ¼ 0.364. PNI-O was the method with the highest overall agreement. Taking this level of agreement into account, we chose the PNI-O as a benchmark method of comparison. The highest positive likelihood ratio for the diagnosis of malnutrition was obtained from the Nutritional Risk Index (13.56). Conclusions: Malnutrition prevalence is high and prevalence estimates vary according the method used, with low concordance among methods. PNI-O and NRI are the most consistent methods to identify malnutrition in these patients.
Nutritional indicators among patients with liver transplantation: A cross sectional study
Journal of Nursing Education and Practice, 2021
Background and objective: The trouble of nutritional state is considered as a prophet of morbidity and mortality in patients with advanced liver disease. The severity of nutritional disorder increases with diminished liver function. The aim of this study was to explore the nutritional indicators among patients with liver transplantation patients in Egypt.Methods: Outlined is a descriptive cross-sectional research design using a convenience sampling of 210 patients following liver transplantation from the outpatient of transplantation centre the Mansura university Hospital, Wady el-Nile Hospital, International Military Medical centre, Almady Military Hospital. Data were collected using an adapted four parts tool that gathered sociodemographic data of patients; data about patient dietary habits and dietary balance and an assessment of patients physical and anthropometric measurements as nutritional predictor’s.Results: There is a highly significant relation between nutritional status,...
Assessment of nutritional support in patients after liver and kidney transplantation
Hrvatski časopis za prehrambenu tehnologiju, biotehnologiju i nutricionizam
During the last decades organ transplantation has evolved into a proven therapy for end-stage organ failure. However, the long-term success of organ transplantation depends significantly on the patients’ ability to overcome possible postoperative complications and to recover from a severe metabolic imbalance. Therefore, in the present study we assessed the accuracy of the early post-operative nutritional intake in a vulnerable group of patients after organ transplantation and compared it with the calculated minimal nutritional requirements. A number of 61 patients were included in the study, 48 with liver, 11 with kidney, and two patients with both, liver and kidney transplants. Mini nutritional assessment (MNA) was applied and total nutritional intake was recorded for fourteen consecutive post-transplant days. Serum concentrations of proteins, urea and creatinine, as well as catalytic concentrations of liver enzymes were measured. Urea to creatinine ratio was calculated. According ...