Beneficial effects of supplementation with branched-chain amino acids on postoperative bacteremia in living donor liver transplant recipients

Liver Transpl. 2011 Sep;17(9):1073-80. doi: 10.1002/lt.22324.

Abstract

The aim of this study was to investigate the effects of preoperative oral supplementation with branched-chain amino acids (BCAAs) on postoperative bacteremia after living donor liver transplantation (LDLT) for chronic liver failure. Two hundred thirty-six patients who underwent adult-to-adult LDLT were evaluated in this retrospective study. The patients were divided into 2 groups: those who received oral supplementation with BCAAs before transplantation (the BCAA group; n = 129) and those who did not (the non-BCAA group; n = 107). Before the LDLT indication was determined, BCAA supplementation was prescribed by a hepatologist to preserve hepatic reserves. The clinical characteristics and the incidence of bacteremia were compared between the 2 groups. As for clinical characteristics, the Child-Pugh scores (P = 0.0003) and the Model for End-Stage Liver Disease scores (P = 0.0008) were significantly higher in the BCAA group versus the non-BCAA group. The incidence of bacteremia for Child-Pugh class C patients was significantly lower in the BCAA group (6/90 or 6.7%) versus the non-BCAA group (11/50 or 22.0%, P = 0.0132). In a multivariate analysis, non-BCAA supplementation was an independent risk factor for bacteremia. In conclusion, preoperative BCAA supplementation might reduce the incidence of bacteremia after LDLT. Nevertheless, this is a preliminary report, and further studies, such as randomized, prospective studies, are necessary to clarify the beneficial effects of BCAA supplementation on postoperative bacteremia after liver transplantation.

MeSH terms

  • Administration, Oral
  • Aged
  • Amino Acids, Branched-Chain / therapeutic use*
  • Bacteremia / metabolism*
  • Biopsy
  • Dietary Supplements
  • Female
  • Humans
  • Liver Failure, Acute / therapy*
  • Liver Transplantation / methods*
  • Living Donors
  • Male
  • Middle Aged
  • Renal Replacement Therapy / methods
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Amino Acids, Branched-Chain