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Nutrition Support in Transplantation and Postoperative Recovery

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 July 2020) | Viewed by 5965

Special Issue Editor


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Guest Editor
Department of Transplantation Surgery, Aristotle University School of Medicine, Thessaloniki, Greece
Interests: liver transplantation; hepatobiliary surgery; pancreatic surgery; kidney transplantation
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Special Issue Information

Dear Colleagues,

I am hoping that this Special Issue of the journal Nutrients will attract a multidisciplinary group of authors (and readers) given the importance of the topic. Transplantation medicine and transplantation surgery represent critical situations of life and death where the transplant team is frequently pushed to the limit in order to achieve a successful result. At the same time, the physiological, immunological, and surgical burden for the transplant recipient is enormous given the frail nature of these patients. It should be no surprise that in these difficult situations, the nutritional status of the patient, both pre- and post-operatively, is critical in order for the surgery to have a successful outcome. The recent progress in our understanding of nutritional needs and balance as well as the different modes of administration of the different types of nutrition only serve to make the choice of the right type of nutrition for the right patient a necessity. This becomes even more complicated if we consider that given that the different types of transplantation (depending on the organ or tissue), the recipients face different health challenges and thus have different nutritional needs. The overall goal of this Special Issue is to address these challenges for the various organs transplanted, as well as propose different nutritional strategies based on the experience of the authors.

Dr. Georgios Tsoulfas
Guest Editor

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Keywords

  • Orthotopic liver transplantation
  • Living donor liver transplantation
  • Hepatic regeneration
  • Renal transplantation
  • Intestinal transplantation

Published Papers (2 papers)

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Research

12 pages, 1498 KiB  
Article
Nutrition Support in Liver Transplantation and Postoperative Recovery: The Effects of Vitamin D Level and Vitamin D Supplementation in Liver Transplantation
by Junshi Doi, Amika Moro, Masato Fujiki, Bijan Eghtesad, Cristiano Quintini, K. V. Narayanan Menon, Koji Hashimoto and Kazunari Sasaki
Nutrients 2020, 12(12), 3677; https://doi.org/10.3390/nu12123677 - 28 Nov 2020
Cited by 12 | Viewed by 2998
Abstract
Vitamin D plays an important role in the arena of liver transplantation. In addition to affecting skeletal health significantly, it also clinically exerts immune-modulatory properties. Vitamin D deficiency is one of the nutritional issues in the perioperative period of liver transplantation (LT). Although [...] Read more.
Vitamin D plays an important role in the arena of liver transplantation. In addition to affecting skeletal health significantly, it also clinically exerts immune-modulatory properties. Vitamin D deficiency is one of the nutritional issues in the perioperative period of liver transplantation (LT). Although vitamin D deficiency is known to contribute to higher incidences of acute cellular rejection (ACR) and graft failure in other solid organ transplantation, such as kidneys and lungs, its role in LT is not well understood. The aim of this study was to investigate the clinical implication of vitamin D deficiency in LT. LT outcomes were reviewed in a retrospective cohort of 528 recipients during 2014–2019. In the pre-transplant period, 55% of patients were vitamin-D-deficient. The serum vitamin D level was correlated with the model for end-stage liver disease (MELD-Na) score. Vitamin D deficiency in the post-transplant period was associated with lower survival after LT, and the post-transplant supplementation of vitamin D was associated with a lower risk of ACR. The optimal vitamin D status and vitamin D supplementation in the post-transplant period may prolong survival and reduce ACR incidence. Full article
(This article belongs to the Special Issue Nutrition Support in Transplantation and Postoperative Recovery)
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14 pages, 1155 KiB  
Article
Nutritional Management and Biochemical Outcomes during the Immediate Phase after Liver Transplant for Methylmalonic Acidemia
by Casey Siegel, Ronen Arnon, Sander Florman, John Bucuvalas and Kimihiko Oishi
Nutrients 2020, 12(10), 2976; https://doi.org/10.3390/nu12102976 - 29 Sep 2020
Cited by 5 | Viewed by 2574
Abstract
Methylmalonic acidemia (MMA) is caused by a deficiency of methyl-malonyl-CoA mutase. It is a multisystemic condition with poor clinical outcomes characterized by frequent metabolic decompensation with acidosis, hyperammonemia and encephalopathy. Restriction of intact protein and supplementation with amino acid-based formula play an important [...] Read more.
Methylmalonic acidemia (MMA) is caused by a deficiency of methyl-malonyl-CoA mutase. It is a multisystemic condition with poor clinical outcomes characterized by frequent metabolic decompensation with acidosis, hyperammonemia and encephalopathy. Restriction of intact protein and supplementation with amino acid-based formula play an important role in its management. Recently, liver transplant (LT) became a treatment option for MMA patients. However, there has been no current consensus on the post-operative nutrition management for MMA patients undergoing transplant, particularly during the initial phase of recovery period with catabolic stressors. We performed a retrospective analysis of clinical and nutritional management as well as biochemical profiles before and after LT in five patients with MMA. Through this study, we observed significant improvement of MMA-associated metabolites after LT. MMA patients were able to tolerate increased intact protein intake post-operatively. At least 1–1.5 g/kg/day of total protein during the acute phase after transplant may be tolerated without worsening of the metabolite levels. This information provides a guide in how to nutritionally manage MMA after LT. Full article
(This article belongs to the Special Issue Nutrition Support in Transplantation and Postoperative Recovery)
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