A prospective study on the effect of recipient nutritional status on outcome in liver transplantation

作者：John Wylie Harrison, Jane McKiernan, James Neuberger · 发表于：Transplant International · 年份：1997 · DOI：10.1111/j.1432-2277.1997.tb00931.x · 被引用次数：119 · 研究领域：Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation、Renal Transplantation Outcomes and Treatments

Abstract In a prospective study, we have examined the effect of nutritional status, using anthropometric measurement, on outcome in 102 consecutive adult patients undergoing elective orthotopic liver transplantation. Mid-arm muscle circumference was calculated from these two measurements. Patient outcome variables were time spent in the intensive therapy unit, total time in hospital, infective complications and mortality within 6 months. Graft outcome variables were early graft function, peak aspartate transaminase, alkaline phosphatase, bilirubin and prothrombin time. Group A patients were below and group B patients above the 25th percentile for mid-arm circumference and triceps skin fold thickness. Eighty-four patients (79 %) were at or below the 25th percentile of anthropometric measurements and 30 patients (28 %) were below the 5th percentile. The median mid-arm muscle circumference in group A was 22.3 (range 16.4–28.9) cm and 25.7 (range 21.7–31.8) cm in group B. The medial albumin level was similar in the two groups. There were significantly more bacterial infections in group A (27/84, 32 %) than in group B (2/22, 8 %; χ= 5.4, P= 0.02). There was a difference in mortality up to 6 months post-op-eratively that failed to reach statistical significance (Wilcoxon-Gehan statistic -199, P= 0.09). There were 11/84 (13 %) deaths in group A and no deaths in group B (χ= 2.8, P= 0.09). Post transplantation, there were significant differences (Kruskal-Wallis Anova) between groups A...