Nutrition management of the hepatic transplant patient

Patients who are candidates for liver transplantation are predisposed to severe nutritional depletion because of their underlying hepatic dysfunction. Nutrition-associated complications, particularly infection and poor wound healing, are common causes of morbidity and mortality among adults with chronic liver disease and malignancy who are referred for liver transplantation. During the preoperative period, maintenance or repletive nutrition is provided to the patient with hepatic failure. The patient's postoperative period is characterized by the catabolic response to a major operation, the progressive improvement of hepatic graft function, and the persistent compensatory renal abnormalities that are associated with liver failure. The nutrition management of the patient with liver failure has been well described. Nutrition intervention during the intraoperative and postoperative periods remains enigmatic. The following case report describes the nutrition management of a liver transplant recipient in the intraoperative and postoperative periods.