Nutritional support for liver transplantation

Identifying caloric and protein requirements

D. J. Plevak, S. R. DiCecco, R. H. Wiesner, M. K. Porayko, H. E. Wahlstrom, D. J. Janzow, K. D. Hammel, S. J D O'Keefe

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objective: To characterize the caloric and protein requirements of patients with end-stage liver disease before and for 28 days after liver transplantation. Design: We prospectively assessed 16 adult patients who were scheduled to undergo liver transplantation between December 1989 and September 1990. Material and Methods: Nitrogen balance, 24-hour urinary creatinine, 3-methylhistidine, and resting energy expenditure were determined before transplantation and on days 1, 3, 5, 14, and 28 after transplantation. The investigators were unaware of the results of these measurements, and patients were fed in accordance with a previously established clinical protocol. Results: Resting energy expenditure did not increase from preoperative values; however, urinary nitrogen and 3-methylhistidine increased significantly after liver transplantation, an indication of protein catabolism from a myofibrillar source. A negative nitrogen balance persisted for 28 days postoperatively. Conclusion: We recommend that caloric intake be determined by using the formulation provided by the Harris-Benedict equation at ideal body weight plus 20%. We also recommend that intake of protein be adjusted on the basis of preoperative nutritional assessment, perioperative hepatic and renal function, and results of tests used to measure the adequacy of administered protein. Parenterally or enterally administered protein of more than 1.2 g/kg daily should be well tolerated in most patients who have undergone liver transplantation.

Original languageEnglish (US)
Pages (from-to)225-230
Number of pages6
JournalMayo Clinic Proceedings
Volume69
Issue number3
StatePublished - 1994

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Nutritional Support
Liver Transplantation
Nitrogen
Proteins
Energy Metabolism
Transplantation
Ideal Body Weight
Nutrition Assessment
End Stage Liver Disease
Clinical Protocols
Energy Intake
Creatinine
Research Personnel
Kidney
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Plevak, D. J., DiCecco, S. R., Wiesner, R. H., Porayko, M. K., Wahlstrom, H. E., Janzow, D. J., ... O'Keefe, S. J. D. (1994). Nutritional support for liver transplantation: Identifying caloric and protein requirements. Mayo Clinic Proceedings, 69(3), 225-230.

Nutritional support for liver transplantation : Identifying caloric and protein requirements. / Plevak, D. J.; DiCecco, S. R.; Wiesner, R. H.; Porayko, M. K.; Wahlstrom, H. E.; Janzow, D. J.; Hammel, K. D.; O'Keefe, S. J D.

In: Mayo Clinic Proceedings, Vol. 69, No. 3, 1994, p. 225-230.

Research output: Contribution to journalArticle

Plevak, DJ, DiCecco, SR, Wiesner, RH, Porayko, MK, Wahlstrom, HE, Janzow, DJ, Hammel, KD & O'Keefe, SJD 1994, 'Nutritional support for liver transplantation: Identifying caloric and protein requirements', Mayo Clinic Proceedings, vol. 69, no. 3, pp. 225-230.
Plevak DJ, DiCecco SR, Wiesner RH, Porayko MK, Wahlstrom HE, Janzow DJ et al. Nutritional support for liver transplantation: Identifying caloric and protein requirements. Mayo Clinic Proceedings. 1994;69(3):225-230.
Plevak, D. J. ; DiCecco, S. R. ; Wiesner, R. H. ; Porayko, M. K. ; Wahlstrom, H. E. ; Janzow, D. J. ; Hammel, K. D. ; O'Keefe, S. J D. / Nutritional support for liver transplantation : Identifying caloric and protein requirements. In: Mayo Clinic Proceedings. 1994 ; Vol. 69, No. 3. pp. 225-230.
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