A vitamin D protocol post-liver transplantation

Adults with compromised liver function are inherently deficient and especially vulnerable to the consequences of vitamin D deficiency. Consequences of vitamin D deficiency include liver disease progression, infection, and graft failure. A vitamin D supplementation protocol is proposed to systematically optimize serum vitamin D levels according to guidelines in both pre- and post-liver transplanted patients.

This quasiexperimental study included a sample of N = 45 post-liver transplanted patients taking daily cholecalciferol (vitamin D3) 2500 units for 12 weeks, with a pre- and post-lab measure of serum 25-hydroxyvitamin D levels at a large academic facility.

Seventy-eight percent of patients reached minimum guideline levels using the protocol with an average increase of serum vitamin D of 13.8 ng/mL. Long-term outcomes of clinical significance may include decreased incidence of acute T-cell-mediated graft rejection and infections in the immunocompromised patient.

Optimizing vitamin D in vulnerable patient populations such as chronic liver disease and the immunosuppressed posttransplanted patient has the potential to curtail complications of vitamin D deficiency. As a result, nurse practitioners employing a vitamin D protocol can create a favorable impact on patient quality of life, safety, and healthcare spending.