Effects of Addition of Early Enteral Nutritional Support During the Postoperative Phase in Patients after Living-Donor Liver Transplantation.

Abstract

Early initiation of enteral nutrition is recommended after some surgical procedures. This study retrospectively analyzed the effects of addition of early enteral nutrition (EEN) support during the postoperative phase in patients after living-donor liver transplantation (LDLT). The subjects were adult patients who underwent LDLT in our department and received either total parenteral nutrition (TPN) or EEN for postoperative nutritional support. We retrospectively compared clinical parameters between the TPN group (n=50) and the EEN group (n=45). There were no significant differences in preoperative demographic data between the EEN and TPN groups with the exception of the follow-up period after surgery. In the EEN group, EEN was provided uneventfully; the daily amount of enteral nutrition was 996±465 kcal on postoperative day 7. Central venous catheters were removed significantly earlier in the EEN group than in the TPN group (postoperative day 11±7 vs. 28±18). The postoperative C-reactive protein level and the incidence of bacterial infection were significantly lower in the EEN group than in the TPN group. The postoperative length of hospital stay was significantly shorter and 6-month survival was significantly higher in the EEN group than in the TPN group. A multivariate analysis indicated that EEN was a significant factor for both shorter hospital stay and 6-month survival. Our retrospective analyses suggest that introduction of EEN had a great impact on postoperative short-term outcomes of LDLT.