Nutritional status of patients with alcoholic cirrhosis undergoing liver transplantation: Time trends and impact on survival

Ashwani K. Singal, Patrick S. Kamath, Nickie Francisco Ziller, Sara Dicecco, M. Shoreibah, Walter Kremers, Michael R. Charlton, Julie K. Heimbach, Kymberly D. Watt, Vijay H. Shah

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Alcoholic cirrhotics evaluated for liver transplantation are frequently malnourished or obese. We analyzed alcoholic cirrhotics undergoing transplantation to examine time trends of nutrition/weight, transplant outcome, and effects of concomitant hepatitis C virus (HCV) and/or hepatocellular carcinoma (HCC). Nutrition and transplant outcomes were reviewed for alcoholic cirrhosis with/without HCV/HCC. Malnutrition was defined by subjective global assessment. Body mass index (BMI) classified obesity. A total of 261 patients receiving transplants were separated (1988-2000, 2001-2006, and 2007-2011) to generate similar size cohorts. Mean BMI for the whole cohort was 28 ± 6 with 68% classified as overweight/obese. Mean BMI did not vary among cohorts and was not affected by HCV/HCC. While prevalence of malnutrition did not vary among cohorts, it was lower in patients with HCV/HCC (P < 0.01). One-year graft/patient survival was 90% and not impacted by time period, HCV/HCC, or malnutrition after adjusting for demographics and model end-stage liver disease (MELD). Alcoholic cirrhotics undergoing transplantation are malnourished yet frequently overweight/obese. Among patients selected for transplantation, 1-year post-transplant graft/patient survival is excellent, have not changed over time, and do not vary by nutrition/BMI. Our findings support feasibility of liver transplantation for alcoholic cirrhotics with obesity and malnutrition.

Original languageEnglish (US)
Pages (from-to)788-794
Number of pages7
JournalTransplant International
Volume26
Issue number8
DOIs
StatePublished - Aug 2013

Keywords

  • alcoholic liver disease
  • hepatitis C virus
  • hepatocellular carcinoma
  • malnutrition
  • mortality
  • orthotopic liver transplantation

ASJC Scopus subject areas

  • Transplantation

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