Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Review Article Volume 4 Issue 8

Nutrition Therapy a Cardinal and Unmapped Aspect in Liver Transplantation: A Review

Neha Bakshi1* and Kalyani Singh2

1Assistant Professor, Lady Irwin College, University of Delhi, India 2Former Associate Professor, Lady Irwin College, University of Delhi, India

*Corresponding Author: Neha Bakshi, Assistant Professor, Lady Irwin College, University of Delhi, India.

Received: June 23, 2021; Published: July 23, 2021


  Managing nutrition status is challenging among Liver transplant patients. Symptoms of liver failure like ascites and low albumin levels represent demo in nutrition status assessment. Despite this, malnutrition is prevalent in more than 80% of pre-LT patients. Malnutrition has been associated with poor surgical outcomes; therefore, the need for aggressive nutrition therapy before and after the liver transplant is crucial. Hence, this review aims to accentuate the need for nutrition interventions to devise a nutrition therapy plan in all the phases of Liver transplant.

Keywords: Nutrition Therapy; Liver Transplantation; Malnutrition


  1. Kumaran Vinay. "Liver Transplantation in India”. Textbook of Surgical Gastroenterology Volumes 1.2 (2016): 1172.
  2. Kakodkar Rahul., et al. “Liver transplantation in India: its evolution, problems and the way forward”. (2007): 53-56.
  3. Institute of Health Metrics, Evaluation Global Burden of Disease. GBD 2010 Leading Causes and Risks by Region Heat Map; 1990 and (2019).
  4. Gopal Palepu B., et al. “Critical care issues in adult liver transplantation”. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine 3 (2009): 113.
  5. Kerwin Andrew J and Michael S Nussbaum. "Adjuvant nutrition management of patients with liver failure, including transplant”. Surgical Clinics3 (2011): 565-578.
  6. Bakshi Neha and Kalyani Singh. "Nutrition assessment and its effect on various clinical variables among patients undergoing liver transplant”. Hepatobiliary Surgery and Nutrition4 (2016): 358.
  7. Tandon Puneeta., et al. “Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value”. Liver Transplantation10 (2012): 1209-1216.
  8. Masuda Toshiro., et al. “Sarcopenia is a prognostic factor in living donor liver transplantation”. Liver Transplantation4 (2014): 401-407.
  9. Child CG and Turcotte JG. “Surgery and portal hypertension”. Major Problems in Clinical Surgery 1 (1964):1.
  10. Campillo Bernard., et al. “Validation of body mass index for the diagnosis of malnutrition in patients with liver cirrhosis”. Gastroentérologie Clinique et Biologique 10 (2006): 1137-1143.
  11. Merli Manuela., et al. “Malnutrition is a risk factor in cirrhotic patients undergoing surgery”. Nutrition 11-12 (2002): 978-986.
  12. Johansen Kirsten L., et al. “Longitudinal study of nutritional status, body composition, and physical function in hemodialysis patients”. The American Journal of Clinical Nutrition4 (2003): 842-846.
  13. Toso Silvia., et al. “Bioimpedance vector pattern in cancer patients without disease versus locally advanced or disseminated disease”. Nutrition6 (2003): 510-514.
  14. Fernandes Sabrina Alves., et al. “Nutritional assessment in patients with cirrhosis”. Arquivos de Gastroenterologia1 (2012): 19-27.
  15. Bakshi Neha and Kalyani Singh. "Nutrition assessment in patients undergoing liver transplant”. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine 18.10 (2014): 672.
  16. Plauth M., et al. “ESPEN guidelines on enteral nutrition: liver disease”. Clinical Nutrition2 (2006): 285-294.
  17. Wagner D., et al. “Serum albumin, subjective global assessment, body mass index and the bioimpedance analysis in the assessment of malnutrition in patients up to 15 years after liver transplantation”. Clinical Transplantation4 (2011): E396-E400.
  18. Bischoff Stephan C., et al. “ESPEN practical guideline: Clinical nutrition in liver disease”. Clinical Nutrition 12 (2020): 3533-3562.
  19. Bakshi Neha and Kalyani Singh. "Effect of malnutrition on health related quality of life (HRQoL) of patients awaiting liver transplantation”. Indian Journal of Transplantation 9 (2015): 62.
  20. Bakshi Neha and Kalyani Singh. "Diet and nutrition therapy in pre-liver transplant patients”. Hepatoma Research 2 (2016): 207-215.
  21. Müller MJ., et al. “Are patients with liver cirrhosis hypermetabolic?”. Clinical Nutrition 3 (1994): 131-144.
  22. Campillo Bernard., et al. “The thermogenic and metabolic effects of food in liver cirrhosis: consequences on the storage of nutrients and the hormonal counterregulatory response”. Metabolism5 (1992): 476-482.
  23. Plauth Mathias., et al. “ESPEN guidelines on parenteral nutrition: hepatology”. Clinical Nutrition4 (2009): 436-444.
  24. Akbar Samina., et al. “Polyunsaturated Fatty Acids: Impact on Health and Disease Status”. Life and Science2 (2021): 12-12.
  25. Ginanni Corradini Stefano., et al. “Plasma fatty acid lipidome is associated with cirrhosis prognosis and graft damage in liver transplantation”. The American Journal of Clinical Nutrition2 (2014): 600-608.
  26. Swart GR., et al. “Effect of a late evening meal on nitrogen balance in patients with cirrhosis of the liver”. British Medical Journal6709 (1989): 1202-1203.
  27. Nielsen Klaus., et al. “Long-term oral refeeding of patients with cirrhosis of the liver”. British Journal of Nutrition4 (1995): 557-567.
  28. Plauth Merli., et al. “ESPEN guidelines for nutrition in liver disease and transplantation”. Clinical Nutrition 2 (1997): 43-55.
  29. Weimann A., et al. “ESPEN guidelines on enteral nutrition: surgery including organ transplantation”. Clinical Nutrition 2 (2006): 224-244.
  30. Sanchez Antonio J and Jaime Aranda‐Michel. "Nutrition for the liver transplant patient”. Liver Transplantation 9 (2006): 1310-1316.
  31. Schenker Steven and Glenn A Halff. "Nutritional therapy in alcoholic liver disease”. Seminars in liver by Thieme Medical Publishers, Inc 13.2 (1993).
  32. Leevy Carroll M and Şerban A Moroianu. "Nutritional aspects of alcoholic liver disease”. Clinics in Liver Disease1 (2005): 67-81.
  33. Barbara Mary and Ayse L Mindikoglu. "The role of zinc in the prevention and treatment of nonalcoholic fatty liver disease”. Metabolism Open (2021): 100105.
  34. Pîrvu Daniel-Cristian., et al. “The Role Of Zinc In Chronic Liver Disease”. Research and Science Today 1 (2021): 79A-89.
  35. Bennett MW., et al. “Alterations in plasma magnesium concentrations during liver transplantation”. Transplantation 4 (1993): 859-861.
  36. Ansari Asad Jamal., et al. “An Insight to Hyponatremia in Cirrhosis: Pathophysiology and Management Approaches” (2021).
  37. Bakshi N., et al. “Nutrition in Liver Transplant Recipients: Case Series”. Open Journal of Clinical and Medical Case Reports 1 (2015): 15.
  38. Bakshi N and Singh K. “Nutrition Profile of a Liver Transplant Recipient: A Case Report”. Hepatoma Research 2 (2016): 98-102.
  39. Mathur Sachin., et al. “Hypermetabolism predicts reduced transplant-free survival independent of MELD and Child-Pugh scores in liver cirrhosis”. Nutrition 5 (2007): 398-403.
  40. Figueiredo Fatima., et al. “Impact of nutritional status on outcomes After liver transplantation1”. Transplantation9 (2000): 1347-1352.
  41. Plauth Mathias., et al. “Weight gain after transjugular intrahepatic portosystemic shunt is associated with improvement in body composition in malnourished patients with cirrhosis and hypermetabolism”. Journal of Hepatology2 (2004): 228-233.
  42. Campos Antonio CL., et al. “Nutritional aspects of liver transplantation”. Current Opinion in Clinical Nutrition and Metabolic Care3 (2002): 297-307.
  43. Hasse Jeanette M. "Nutritional implications of liver transplantation”. Henry Ford Hospital Medical Journal4 (1990): 235-240.
  44. Bakshi Neha and Kalyani Singh. "Nutrition management of acute postliver transplant recipients”. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine11 (2018): 773.
  45. Hasse JM., et al. “The effect of nutritional status on length of stay and clinical outcomes following liver transplantation”. Journal of the American Dietetic Association 9 (1994): A38.
  46. Hay JE. "Bone disease in liver transplant recipients”. Gastroenterology Clinics of North America 2 (1993): 337-349.
  47. Figueiredo Fátima AF., et al. “Comparison of three methods of nutritional assessment in liver cirrhosis: subjective global assessment, traditional nutritional parameters, and body composition analysis”. Journal of Gastroenterology 5 (2006): 476-482.
  48. Alberino Franca., et al. “Nutrition and survival in patients with liver cirrhosis”. Nutrition6 (2001): 445-450.


Citation: Neha Bakshi and Kalyani Singh. “Nutrition Therapy a Cardinal and Unmapped Aspect in Liver Transplantation: A Review”. Acta Scientific Gastrointestinal Disorders 4.8 (2021): 44-52.


Copyright: © 2021 Neha Bakshi and Kalyani Singh. 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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