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Nutrition Support and Infections Associated With Hepatic Resection and Liver Transplantation in Patients With Chronic Liver Disease
Authors:Toshiro Masuda MD  PhD  Ken Shirabe MD  PhD  Shohei Yoshiya MD  Rumi Matono MD  Kazutoyo Morita MD  PhD  Naotaka Hashimoto MD  PhD  Toru Ikegami MD  PhD  Tomoharu Yoshizumi MD  PhD  Hideo Baba MD  PhD  Yoshihiko Maehara MD  PhD
Affiliation:1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Abstract:
Malnutrition is common in liver cirrhotic patients who will undergo liver resection or liver transplantation. A precise evaluation of their nutrition status is thus difficult because of the presence of ascites and the edema caused by their impaired protein synthesis. Both perioperative enteral and parenteral nutrition have benefits in reducing the morbidity and mortality of liver surgery, and in general, oral nutrition supplements are recommended. Branched‐chain amino acids (BCAAs) promote protein and glycogen synthesis and regulate immune system function. Synbiotics, a combination of pro‐ and prebiotics, is reported to enhance immune responses. Oral nutrition support with BCAAs, synbiotics, and an immune‐enhancing diet have a beneficial effect on preventing the perioperative infections associated with hepatic resection or liver transplantation.
Keywords:nutrition  infection  bacteremia  liver cirrhosis  liver surgery  hepatic resection  liver transplantation  branched‐chain amino acids  synbiotics
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