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Nutrients. 2018 Jun 19;10(6). pii: E790. doi: 10.3390/nu10060790.

Nutritional Requirements of Lung Transplant Recipients: Challenges and Considerations.

Author information

1
Lung Transplant Program, Centre Hospitalier de l'Université de Montréal, 900 Saint-Denis Street, Montreal, QC H2X 0A9, Canada. valerie.jomphe.chum@ssss.gouv.qc.ca.
2
Lung Transplant Program, Centre Hospitalier de l'Université de Montréal, 900 Saint-Denis Street, Montreal, QC H2X 0A9, Canada. larry.lands@mcgill.ca.
3
Department of Pediatrics, Montreal Children's Hospital-McGill University Health Centre, 1001 Décarie Boulevard, Montreal, QC H4A 3J1, Canada. larry.lands@mcgill.ca.
4
Meakins Christie Laboratories, Research Institute of the McGill University Health Centre, 1001 Décarie Boulevard, Montreal, QC H4A 3J1, Canada. larry.lands@mcgill.ca.
5
Department of Nutrition, Faculty of Medicine, Université de Montreal, 2405 Cote Sainte-Catherine Rd., Montreal, QC H3T 1A8, Canada. genevieve.mailhot@umontreal.ca.
6
Research Centre, CHU Sainte-Justine, 3175 Cote Sainte-Catherine Rd., Montreal, QC H3T 1C5, Canada. genevieve.mailhot@umontreal.ca.

Abstract

An optimal nutritional status is associated with better post-transplant outcomes and survival. Post-lung transplant nutrition management is however particularly challenging as lung recipients represent a very heterogeneous group of patients in terms of age, underlying diseases, weight status and presence of comorbidities. Furthermore, the post-transplant period encompasses several stages characterized by physiological and pathophysiological changes that affect nutritional status of patients and necessitate tailored nutrition management. We provide an overview of the current state of knowledge regarding nutritional requirements in the post-lung transplant period from the immediate post-operative phase to long-term follow-up. In the immediate post-transplantation phase, the high doses of immunosuppressants and corticosteroids, the goal of maintaining hemodynamic stability, the presence of a catabolic state, and the wound healing process increase nutritional demands and lead to metabolic perturbations that necessitate nutritional interventions. As time from transplantation increases, complications such as obesity, osteoporosis, cancer, diabetes, and kidney disease, may develop and require adjustments to nutrition management. Until specific nutritional guidelines for lung recipients are elaborated, recommendations regarding nutrient requirements are formulated to provide guidance for clinicians caring for these patients. Finally, the management of recipients with special considerations is also briefly addressed.

KEYWORDS:

lung transplantation; macronutrients; micronutrients; nutrient requirements; nutrition management; nutritional recommendations; nutritional status

PMID:
29921799
PMCID:
PMC6024852
DOI:
10.3390/nu10060790
[Indexed for MEDLINE]
Free PMC Article

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