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Transpl Int. 2013 Aug;26(8):788-94. doi: 10.1111/tri.12123. Epub 2013 Jun 11.

Nutritional status of patients with alcoholic cirrhosis undergoing liver transplantation: time trends and impact on survival.

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1
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Abstract

Alcoholic cirrhotics evaluated for liver transplantation are frequently malnourished or obese. We analyzed alcoholic cirrhotics undergoing transplantation to examine time trends of nutrition/weight, transplant outcome, and effects of concomitant hepatitis C virus (HCV) and/or hepatocellular carcinoma (HCC). Nutrition and transplant outcomes were reviewed for alcoholic cirrhosis with/without HCV/HCC. Malnutrition was defined by subjective global assessment. Body mass index (BMI) classified obesity. A total of 261 patients receiving transplants were separated (1988-2000, 2001-2006, and 2007-2011) to generate similar size cohorts. Mean BMI for the whole cohort was 28 ± 6 with 68% classified as overweight/obese. Mean BMI did not vary among cohorts and was not affected by HCV/HCC. While prevalence of malnutrition did not vary among cohorts, it was lower in patients with HCV/HCC (P < 0.01). One-year graft/patient survival was 90% and not impacted by time period, HCV/HCC, or malnutrition after adjusting for demographics and model end-stage liver disease (MELD). Alcoholic cirrhotics undergoing transplantation are malnourished yet frequently overweight/obese. Among patients selected for transplantation, 1-year post-transplant graft/patient survival is excellent, have not changed over time, and do not vary by nutrition/BMI. Our findings support feasibility of liver transplantation for alcoholic cirrhotics with obesity and malnutrition.

KEYWORDS:

alcoholic liver disease; hepatitis C virus; hepatocellular carcinoma; malnutrition; mortality; orthotopic liver transplantation

PMID:
23751180
PMCID:
PMC3987667
DOI:
10.1111/tri.12123
[Indexed for MEDLINE]
Free PMC Article
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