Korean J Transplant.  2022 Nov;36(Supple 1):S169. 10.4285/ATW2022.F-2967.

Nutritional management and branched-chain amino acids diet among patients undergoing living donor liver transplantation

• Atmaja EM
• Febristi AR

• KMID: 2535685
• DOI: http://doi.org/10.4285/ATW2022.F-2967

Abstract

Background
End-stage liver disease (ESLD) patients commonly suffer from malnutrition that may increase risk of infections, poor quality of life, and decreased survival after liver transplant (LT). Etiology of malnutrition in ESLD are caused by decreased food intake, malabsorption and hypermetabolism. Branched-chain amino acids (BCAA) and protein intake help to restore mus-cle mass and improve appetite. Maintain BCAA and aromatic amino acids helps to synthesize skeletal muscle which is import-ant to improve nutritional status pre-LT. The aim of this review was to summarize of various intervention of BCAA treatments among ESLD patients before undergoing liver transplant.
Methods
This systematic review was obtained from the analysis and synthesis of recent journals on PubMed, Web of Science and Google Scholar. Relevant study was collected up to August 2022 using the following search terms: BCAA, nutrition pre liver transplant, nutritional management ESLD, malnutrition before liver/hepatic surgery.
Results
Nutritional therapy among ESLD patients concern on providing adequate calories for the efficient use of protein source. Maintaining high nutrient requirement among pre-LT patients can be helps by BCAA enriched supplements. Patients with BCAA groups (received oral BCAA supplementation before transplantation) is significantly higher in Child-Pugh scores (P=0.0003) rather than the non-BCAA group. The incidence of bacteremia was significantly lower in the BCAA groups among pre-LT patients with Child-Pugh class C. Others study showed the same result which the incidence of posttransplant bactere-mia was significantly lower in BCAA groups (P=0.011). Based on nutritional status, BCAA groups showed significantly higher level of pre-albumin (P=0.023) and branched-chain-amino-acids-tyrosine ratio (P=0.046), but preoperative skeletal muscle mass did not significantly different both two groups (P=0.143).
Conclusions
BCAA supplementation may contribute on decreasing of bacteremia incidence post-LT. Others beneficial of BCAA should be observe more to show efficiency of BCAA supplementation before pre-LT to the nutritional status after liver trans-plantation.