Clinical Researches
Effect of early enteral nutrition on recovery of patients with severe hepatitis after liver transplantation
Jianrong Liu, Shilei Xu, Yuling An, Haijin Lyu, Xiaomeng Yi, Xuxia Wei, Liang Xiong, Yingcai Zhang, Yang Yang, Huimin Yi
Published 2015-10-10
Cite as Chin J Hepat Surg(Electronic Edition), 2015, 04(5): 306-310. DOI: 10.3877/cma.j.issn.2095-3232.2015.05.012
Abstract
ObjectiveTo investigate the effects of early enteral nutrition on the recovery of patients with severe hepatitis after liver transplantation (LT).
MethodsThirty-two patients with severe hepatitis undergoing allogeneic orthotopic LT in the Third Affiliated Hospital of Sun Yat-sen University between June 2012 and April 2014 were included in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were randomized into the enteral nutrition group and the parenteral nutrition group according to the random number table method. Among the 14 patients in the enteral nutrition group, all patients were males with the average age of (42±9) years old. Among the 16 patients in the parenteral nutrition group, 14 were males and 2 were females with the average age of (44±10) years old. Patients in the enteral nutrition group were given warm water and lactulose through gastro-jejunal tube 1 d after LT. Enteral nutritional suspension was offered 2 d after LT and gradually increased to 1 000 ml/d, meanwhile, parenteral nutrition was reduced gradually. Patients in the parenteral nutrition group were given parenteral nutrition. Patients in both groups started normal diet after full recovery of the intestinal function. Venous blood was collected before LT and 1, 10 d after LT to examine hepatic and renal function. The recovery of gastroenteric function, hepatic and renal function and incidence of infection were observed 2 weeks after LT. The comparison of the observed indexes of two groups was conducted using t test or rank-sum test and the rate comparison was conducted using Fisher's exact test.
ResultsThe postoperative recovery time of gastroenteric function of the enteral nutrition group was (6.1±1.4) d, which was significantly shorter than (10.6±3.8) of the parenteral nutrition group (t=-4.21, P<0.05). The median ALT, AST, TB, prealbumin and blood urea-nitrogen (BUN) in the enteral nutrition group 10 d after LT were respectively 106 (50-163) U/L, 62 (27-135) U/L, 67 (35-116) μmol/L, 201 (105-389) mg/L and 12.5 (6.4-18.8) mmol/L, and those in the parenteral nutrition group were respectively 276 (46-716) U/L, 119 (33-447) U/L, 131 (89-391) μmol/L, 162 (103-238) mg/L and 26.1(12.9-37.6) mmol/L. Significant difference was observed (Z=-3.76, -3.15, -4.01, 2.93, -3.79; P<0.05). The incidence of infection of the enteral nutrition group 2 weeks after LT was 43% (6/14), which was significantly lower than 69% (11/16) of the parenteral nutrition group (P<0.05).
ConclusionCompared with parenteral nutrition, early enteral nutrition after LT may promote the recovery of gastroenteric function, improve the hepatic and renal function and nutritional situation and reduce the incidence of postoperative infection, which is beneficial to postoperative recovery.
Key words:
Enteral nutrition; Parenteral nutrition; Hepatitis; Liver transplantation; Prognosis
Contributor Information
Jianrong Liu
Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
Shilei Xu
Yuling An
Haijin Lyu
Xiaomeng Yi
Xuxia Wei
Liang Xiong
Yingcai Zhang
Yang Yang
Huimin Yi
