Effects of Post‐transplant Enteral Nutrition with an Immunomodulating Diet Containing Hydrolyzed Whey Peptide after Liver Transplantation

Abstract

Complications due to infections, including bacteremia, often arise after liver transplantation (LT) and are the most frequent causes of in-hospital death. Hydrolyzed whey peptide (HWP), a protein complex derived from milk, has anti-inflammatory effects. The present study retrospectively analyzes the effects of early enteral nutrition with a new immunomodulating diet (IMD) enriched with HWP in patients after living-donor LT (LDLT). Data from 76 consecutive adult patients who underwent LDLT at our institute between September 2009 and March 2011 were retrospectively analyzed. The new IMD enriched with HWP and a conventional elemental diet were administered enterally to 40 (HWP group) and 36 (control group) patients, respectively, within the first 24 h after surgery. The characteristics of patients and surgical parameters did not differ between the two groups. The incidence of bacteremia was significantly lower in the HWP (15%) than in the control group (47%) (p = 0.002). The in-hospital mortality due to infection was a little lower in the HWP group than in the control group, although there was no statistical difference (p = 0.145). The fasting blood glucose level at postoperative day 7 was significantly lower in the HWP group than in the control group (p = 0.005). The incidence of acute cellular rejection was similar between the two groups (p = 0.858). Early enteral nutrition with the new IMD enriched with HWP can prevent post-transplant bacteremia and post-transplant hyperglycemia without increasing the incidence of acute cellular rejection.