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Immunonutrition failed to improve nutritional status, reduce infection after liver transplant
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In a cohort of patients wait-listed for liver transplantation, perioperative immunonutrition did not improve preoperative nutritional status, positively affect postoperative recovery or reduce postoperative infection, according to recent study data.
“The primary objective of the current randomized trial was to investigate the effect of supplemental immunonutrition on preoperative body protein stores, as an objective marker of nutritional status, in patients undergoing elective [liver transplantation],” the researchers wrote.
Researchers enrolled 120 patients wait-listed for orthotopic liver transplantation at the New Zealand Liver Transplant Unit of Auckland City Hospital and randomly assigned them to 0.6 L of oral immunonutrition (IMN) or isocaloric control (CON). Of these patients, 101 (52 in the IMN group, 49 in the CON group) underwent transplantation and were included in final analyses.
Preoperative changes in total body protein of the patients were not significantly affected by the IMN (0.06 ± 0.15 kg) or CON (0.12 ± 0.1 kg). However, when compared with baseline characteristics, the two groups experienced a 0.7 ± 0.2 kg decrease in total body protein 30 days postoperative (P<.0001). After 360 days, the total body protein had not increased a significant amount in either the IMN group (0.08 ± 0.19 kg) or CON group (0.26 ± 0.23 kg), according to the research.
Sixty percent of patients in the IMN group (n=31) and 57% in the CON group (n=28) experienced some sort of infectious complication (P=.84) within the first 30 days after transplantation. The median hospital stay after transplantation was 10 days for both IMN and CON patients (P=.68).
“We did not demonstrably improve nutritional status of waiting list patients prior to transplant with an immunonutritional intervention nor did we find evidence of improved early infectious complication rates post-transplant,” the researchers concluded. “Although the rate of major complications over 12 months following surgery was lower in the IMN arm, the difference was not significant and a larger study would be needed to explore this further.”
Disclosure: The researchers report no relevant financial disclosures.