TY - JOUR
T1 - Nutritional Support for Liver Transplantation
T2 - Identifying Caloric and Protein Requirements
AU - PLEVAK, DAVID J.
AU - DICECCO, SARA R.
AU - WIESNER, RUSSELL H.
AU - PORAYKO, MICHAEL K.
AU - WAHLSTROM, H. ERIK
AU - JANZOW, DENISE J.
AU - HAMMEL, KRIS D.
AU - O'KEEFE, STEPHEN J.D.
N1 - Funding Information:
This study was supported in part by the Mayo Foundation.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1994
Y1 - 1994
N2 - To characterize the caloric and protein requirements of patients with end-stage liver disease before and for 28 days after liver transplantation. We prospectively assessed 16 adult patients who were scheduled to undergo liver transplantation between December 1989 and September 1990. 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. 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. 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.
AB - To characterize the caloric and protein requirements of patients with end-stage liver disease before and for 28 days after liver transplantation. We prospectively assessed 16 adult patients who were scheduled to undergo liver transplantation between December 1989 and September 1990. 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. 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. 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.
KW - REE
KW - resting energy expenditure
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U2 - 10.1016/S0025-6196(12)61060-X
DO - 10.1016/S0025-6196(12)61060-X
M3 - Article
C2 - 8133659
AN - SCOPUS:0028269570
SN - 0025-6196
VL - 69
SP - 225
EP - 230
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 3
ER -