Effects of early postoperative nutritional support on enhanced recovery after lung transplantation

The optimal postoperative nutritional management after lung transplantation (LT) remains unclear. This study evaluated the effectiveness of an early postoperative nutritional protocol on the nutrition-related outcomes.

We retrospectively analyzed 50 patients who underwent LT between 2019 and 2021 at our institution. From 2020, 22 patients were managed using a nutritional protocol aiming to initiate nutritional support by postoperative day (POD) 3 and achieve the target energy and protein intake by POD 7. Postoperative changes in body weight and muscle mass were compared between the pre- and post-protocol groups over a period of 3 months.

The perioperative characteristics were comparable between the groups. The initiation of enteral and central parenteral nutrition within 3 days was more frequent in the post-protocol group than in the pre-protocol group (45% vs. 7%, p = 0.002; 82% vs. 29%, p < 0.001). Energy and protein sufficiency on POD 7 was higher in the post-protocol group (84% vs. 69%, p = 0.011; 87% vs. 74%, p = 0.017). Weight loss at 2 weeks after LT was attenuated in the post-protocol group and remained suppressed. Although muscle mass declined at 2 weeks in both groups, recovery within 3 months was greater in the post-protocol group.

Early postoperative nutritional support after LT is associated with reduced weight loss and an improved muscle mass recovery.