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Nutrition and the transplant candidate.
Liver Transpl 2017; 23(11):1451-1464LT

Abstract

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. Despite the high prevalence and important prognostic role, malnutrition and sarcopenia are frequently overlooked because standards for nutritional assessment are lacking and challenges such as fluid retention and obesity are prevalent. In this review, current diagnostic methods to evaluate malnutrition, including muscle abnormalities in cirrhosis, are discussed and current knowledge regarding the incidence and clinical impact of malnutrition in cirrhosis and its impact after LT are presented. Existing and potential novel therapeutic strategies for malnutrition in cirrhosis are also discussed, emphasizing the treatment of muscle wasting in the LT candidate in an effort to improve survival while waiting for LT and to reduce morbidity and mortality after LT.Liver Transplantation 23 1451-1464 2017 AASLD.

Authors+Show Affiliations

Divisions of Human Nutrition.Gastroenterology and Liver Unit, University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada.Gastroenterology and Liver Unit, University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29072825

Citation

Mazurak, Vera C., et al. "Nutrition and the Transplant Candidate." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 23, no. 11, 2017, pp. 1451-1464.
Mazurak VC, Tandon P, Montano-Loza AJ. Nutrition and the transplant candidate. Liver Transpl. 2017;23(11):1451-1464.
Mazurak, V. C., Tandon, P., & Montano-Loza, A. J. (2017). Nutrition and the transplant candidate. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 23(11), pp. 1451-1464. doi:10.1002/lt.24848.
Mazurak VC, Tandon P, Montano-Loza AJ. Nutrition and the Transplant Candidate. Liver Transpl. 2017;23(11):1451-1464. PubMed PMID: 29072825.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition and the transplant candidate. AU - Mazurak,Vera C, AU - Tandon,Puneeta, AU - Montano-Loza,Aldo J, PY - 2017/05/12/received PY - 2017/07/07/revised PY - 2017/08/01/accepted PY - 2017/10/27/entrez PY - 2017/10/27/pubmed PY - 2018/6/22/medline SP - 1451 EP - 1464 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 23 IS - 11 N2 - 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. Despite the high prevalence and important prognostic role, malnutrition and sarcopenia are frequently overlooked because standards for nutritional assessment are lacking and challenges such as fluid retention and obesity are prevalent. In this review, current diagnostic methods to evaluate malnutrition, including muscle abnormalities in cirrhosis, are discussed and current knowledge regarding the incidence and clinical impact of malnutrition in cirrhosis and its impact after LT are presented. Existing and potential novel therapeutic strategies for malnutrition in cirrhosis are also discussed, emphasizing the treatment of muscle wasting in the LT candidate in an effort to improve survival while waiting for LT and to reduce morbidity and mortality after LT.Liver Transplantation 23 1451-1464 2017 AASLD. SN - 1527-6473 UR - https://www.unboundmedicine.com/medline/citation/29072825/Nutrition_and_the_transplant_candidate_ L2 - https://doi.org/10.1002/lt.24848 DB - PRIME DP - Unbound Medicine ER -