Korean J Transplant.  2022 Nov;36(Supple 1):S208. 10.4285/ATW2022.F-3478.

Early enteral nutrition in post-liver transplantation patient

• Febristi AR
• Atmaja EM

• KMID: 2535273
• DOI: http://doi.org/10.4285/ATW2022.F-3478

Abstract

Background
Malnutrition is commonly found in patients with liver transplantation and associated with morbidity, mortality, and high costs of posttransplantation setting. The transplant procedure increased catabolism system and energy demand. Therefore, it is essential for patients to receive the sufficient of nutrition to promote recovery, wound healing and prevent infection. The aim of this review was to discuss the nutritional management among patients with liver transplantation.
Methods
This review was conducted by searching several studies using the keyword nutrition and liver transplantation and 15,870 studies were identified. Based on the article titles and removal of those not relevant, 40 studies were selected for further appraisal. After reading the full article, this review was performed by six studies.
Results
Early enteral nutrition feeding showed an effective result in patients after liver transplantation. A study indicates that changes in daily calory intake (DCI) showed nutritional advantages in enteral nutrition (EN) subjects over the total parenteral nutrition (TPN) patient. EN patients received more than 20 kcal/kg/d within the postoperative day (POD) 7 and TPN patient received less than 20 kcal/kg/d when patient started oral intake on the POD 9. Other than that, the incidences of bacterial in-fections in patients who did not receive enteral feeding was significantly higher than LDLT recipients who receive early enteral nutrition. Bacterial infections occurred in 63.2% in patients with intravenous fluid compared with 29.4% of the early enteral nutrition group (P=0.043). Several studies also revealed that fiber, probiotics, and early enteral nutrition formula enriched with hydrolyzed whey peptide could lower the incidence of bacterial infections.
Conclusions
Early enteral nutrition was associated with significantly reduced risk of developing bacterial infections. It also reduced the possibility of mortality as the results of decreased infectious complications.