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Table 3: Patients’ biochemical profile after discharge
Days after Hb WBC Platelets Bil (T) Bil (D) AST ALT Alkaline γ glutamyl Alb Na K Cr
3
3
discharge (mg/dL) (10 /UL) (10 /UL) (mg/dL) (mg/dL) (IU/L) (IU/L) phosphates transferase (IU/L) (g/dL) (mmol/L) (mmol/L) (mg)
1 9.5 12.02 40 8 6.3 54 117 92 245 1.8 136 3.8 0.8
2 8.9 11.02 50 7.7 6 44 92 94 284 2 137 3.8
3 9.3 16.2 70 8.7 7 41 92 113 311 2.3 137 4.1 0.8
4 9.3 17.18 95 7 5.4 45 92 122 348 2.4 134 4.3 0.8
5 9.5 21.93 163 5.6 4.4 47 95 362 2.4 134 5.4 0.8
6 9.6 25.6 200 4 3 34 84 167 396 2.2 132 5.1 0.9
7 9.7 20.51 252 3.6 2.7 35 89 245 428 2.3 129 6 1
8 9.6 16.13 242 3.2 2.3 41 74 314 552 2.2 129 5.8 1
9 9.2 8.09 185 1.5 0.9 30 117 82 195 1.9 131 4.6 0.8
10 10.3 10.17 355 3 2.2 51 109 421 772 2.4 131 5.5 0.9
12 9 13.14 305 2.1 1.6 52 78 287 733 2.2 133 4.1 1
15 9 13.19 300 2.3 2 105 196 294 737 2.3 137 3.3 0.9
19 9.8 17.86 373 2 1.7 67 221 325 828 2.6 138 3.7 0.9
26 11.20 15.48 301 1.0 0.8 57 119 213 623 2.50 1.0
33 11.30 17.37 312 0.7 0.7 42 86 178 474 2.50 4.0 0.8
34 11.70 13.27 311 0.7 0.5 39 83 162 449 2.60
41 12.40 14.80 326 0.6 44 91 169 382 2.90 135 5.3 0.9
53 11.30 13.05 328 0.3 0.2 38 69
54 12.20 13.22 308 0.5 0.4 55 102 160 283 2.70
72 10.90 22.63 0.6 0.2 29 42 220 4.90 146 4.2 1.3
88 0.4 0.3 23 32 116 107 3.10 140 4.8
Hb: haemoglobin; WBC: white blood cell; Alb: albumin; Bili: bilirubin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; Cr: creatinine
Table 4: Comparison of nutritional status in pre-transplant has also been associated with poor surgery outcome
and chronic post-transplant phase (3 months after LT) and increased morbidity and mortality. In India, LT is a
Pre- Post-transplant relatively new area, and there is a lack of data about the
transplant (3 months after
transplant) general and nutritional profile of patients undergoing
Anthropometric evaluation LT. It is essential to identify and correct nutritional
Weight (kg) 73.9 78.6
Height (cm) 176 176 deficiencies in LT recipients. Hence, this case report
[7]
Triceps (cm) 0.56 1.5 provides information on the day to day nutrition profile
[7]
MAMC (cm) 22 21.2 and the medical nutrition therapy of a LT recipient with
SGA [8]
SGA (score) 6 2 the aim of improving outcomes.
[8]
Body composition analysis
by bioelectrical impedance
analysis [9] A gradual improvement in the nutrition, biochemical,
Weight (kg) 72.55 76.6 and functional parameters was seen after 3 months of
Fat (%) 22.5 28 transplant. Nutrition assessment by SGA, triceps, and
Fat mass (kg) 16.3 21.45
FFM (kg) 56.25 55.15 body composition analysis showed better nutrition
Muscle mass (kg) 53.35 52.3 status 3 months after LT. During the acute post-transplant
TBW (%) 53.5 47.6 phase, continuous observation by medical and nutrition
BMI 23.2 24.5
Bone mass (kg) 2.90 2.85 experts helped to fulfill nutritional needs through various
MAMC: mid-arm muscle circumference; SGA: subjective global assessment; feeding routes. However, the difference in calorie and
FFM: fat-free mass; TBW: total body water; BMI: body mass index; LT: liver protein intake in chronic post-transplant phase is due to
transplantation
lack of counseling from nutrition experts. Hence, proper
strength (both hands) showed severe malnutrition nutrition monitoring is required during all phases of
similar to pre-transplant phase. [9] transplant to maintain the overall health of the patient.

DISCUSSION Acknowledgments
Dr. A. S. Soin: Chief Hepatobiliary and Liver Transplant
A high incidence of malnutrition has been seen in LT Surgeon and Chairman of Medanta Institute of Liver
recipients. [5,14,15] Accurate estimation of the nutritional Transplantation and Regenerative Medicine, Medanta,
status of patients with ESLD presents a major challenge The Medicity, Gurgaon, India, for permitting the author
due to fluid retention found in patients and the effect to collect information regarding liver transplant patients
of liver function on protein synthesis. Malnutrition from their institute.
[16]

Hepatoma Research | Volume 2 | April 1, 2016 101