Preoperative nutrition and postoperative liver function： a correlation study of pediatric living donor liver transplantation

摘要

Objective: There is little information focusing on the nutritional issue of pediatric recipients before they receive living donor liver transplantation. This study illustrates the relationship between nutritional status and graft liver function and provides a reference regarding nutritional interventions in future studies.Methods: We prospectively collected data from 30 pediatric living donor liver transplant recipients from January 1,2016, to June 30,2016. The information included demographic data, preoperative nutritional assessment, and postoperative laboratory examinations.The nutritional assessment included the serum concentration of vitamin D, bone density, trace element, and weight Z value. The laboratory examinations included white blood cell count, neutrophil percentage, hemoglobin, blood platelet, total protein, albumin,total bilirubin, direct bilirubin, alanine transaminase, aspartate aminotransferase(AST), alkaline phosphatase, gamma-glutamyl transpeptidase, creatinine, bile acid, blood glucose(Glu), prothrombin time, international normalized ratio, tacrolimus concentration,and graft-to-recipient weight ratio(GRWR). The data were collected on Days 1,2,3,4,5,6,7,14,30, and 60 after liver transplantation.Results: The recipients consisted of 15(50%) males and 15(50%) females. The median age was 7 months(4-48 months). The mean height and weight were 69.07±9.98 cm and 8.09±2.63 kg, respectively. According to the univariate analysis, the gender, diagnosis,blood type, and GRWR did not significantly impact the liver function after the operation. The posttransplantation AST levels and Glu showed significant differences in terms of the nutritional status, with P<0.05. The multivariate correlation analysis showed that the serum concentrations of vitamin D and AST were midrange positively correlated, with P<0.05.Conclusions: The nutritional status of patients with biliary atresia is relatively poor. There is a definite midrange positive correlation between nutrition and graft liver function that might play a relatively important role in the recovery of the graft.