Early enteral nutrition after liver transplantation reducing the incidence of postoperative infection in patients with end-stage liver disease

Abstract

Objective To explore the influences of early enteral nutrition (EN) in the incidence of postoperative infection for patients after liver transplantation. Methods All the liver transplant patients between June 2012 and January 2015 in our center were collected in a prospective cohort study. This study enrolled 177 patients, including 60 patients in early enteral group who started initial enteral nutrition within 24 hours after surgery, and 117 patients who started with total parenteral nutrition (TPN) and did not start EN until anus exhaustion or defecation. Patients were classified according to the Model for End Stage Liver Disease (MELD) score. The effect of early enteral nutrition at different levels were analyzed to view whether the effect in patients with different levels was selective. Results One hundred and six cases (59.9%) were reported postoperative infection. Gender, MELD score and early enteral nutrition were independent risk factors affecting total infection rate (P=0.027, 0.045, 0.000). Early enteral nutrition reduced the infection rate in less severe patients, especially in patients whose MELD score was between 11-20 (P=0.014). With the increase of MELD score, the influence of early enteral nutrition on infection rates gradually narrowed. Conclusion Early enteral nutrition can significantly reduce the incidence of infection in patients with medium MELD score after transplantation. Key words: Liver transplantation; Enteral nutrition; Postoperation; Infection