Nutritional Status and the Impact of Immunonutrition in Liver Transplantation

Abstract

In patients undergoing liver transplantation, various abnormalities in carbohydrate, lipid, and protein metabolism arise due to end-stage liver failure. These conditions lead to clinical deterioration and malnutrition. Malnutrition is present in many liver transplant patients and is associated with increased morbidity and mortality. Evaluating nutritional status and identifying and correcting nutritional deficiencies is extremely important for these patients. Nutritional counseling and necessary interventions can prevent these disorders. In this context, dietitians play a complementary role as part of the transplant team by providing appropriate nutritional therapy to address various nutritional issues. Adequate nutritional support should be provided at all stages of the transplant process. Nutritional therapy should continue in the pre-transplant, peri-transplant, and post-transplant periods. Immunonutrition provided before and after transplantation is beneficial for improving the nutritional status of malnourished patients. This review aims to examine the methods used to evaluate nutritional status before and after liver transplantation, as well as pre- and post-transplant nutritional recommendations and therapies.

Keywords

• Liver
• transplantation
• immunonutrition
• nutritional status

Karaciğer Transplantasyonunda Beslenme Durumu ve İmmünonütrisyonun Etkisi

Abstract

Karaciğer nakli yapılan hastalarda, son dönem karaciğer yetmezliği nedeniyle karbonhidrat, lipit ve protein metabolizmasında çeşitli anormallikler ortaya çıkar. Bu durum, klinik durumda bozulmaya ve malnütrisyona yol açar. Malnütrisyon, karaciğer nakli yapılan hastaların birçoğunda mevcuttur ve artan morbidite ve mortalite ile ilişkilidir. Bu hastalarda beslenme durumunun değerlendirilmesi, beslenme eksikliklerinin belirlenmesi ve düzeltilmesi için son derece önemlidir. Beslenme danışmanlığı ile gerektiğinde müdahale sağlanarak bu bozukluklar önlenebilir. Bu bağlamda diyetisyen, çeşitli beslenme sorunlarının çözümü için uygun beslenme tedavisi sağlayarak nakil ekibinin bir parçası olarak tamamlayıcı bir rol oynar. Naklin tüm aşamalarında yeterli beslenme desteği sağlanmalıdır. Beslenme tedavisi nakil öncesi, nakil esnası ve nakil sonrası dönemde devam etmelidir. Yetersiz beslenen hastalar için, nakil öncesi ve sonrası dönemde sağlanan immünonütrisyon, beslenme durumunun iyileşmesinde faydalı olmaktadır. Bu derleme kapsamında, karaciğer nakli yapılan hastalarda nakil öncesi ve sonrasında beslenme durumunun değerlendirilmesi adına kullanılan yöntemleri, nakil öncesi ve sonrası beslenme önerilerini ve tedavileri gözden geçirmek amaçlanmıştır.

Keywords

• Karaciğer
• organ nakli
• immünonütrisyon
• beslenme durumu

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