Association between artificial nutrition in brain dead donors and early allograft function in liver transplant recipients: an observational study.

brain dead donor cirrhosis critically ill patient donor management donor risk index enteral nutrition ischemia-reperfusion injury liver transplantation organ procurement

Journal

Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240

Informations de publication

Date de publication:
09 2023
Historique:
revised: 23 04 2023
received: 23 07 2022
accepted: 13 05 2023
medline: 8 9 2023
pubmed: 22 5 2023
entrez: 22 5 2023
Statut: ppublish

Résumé

The role of nutrition in donor after brain deaths (DBDs) has yet to be adequately discussed. The primary aim of this study was to investigate whether the nutritional intake in the 48 h before organ retrieval may play a role on the graft functional recovery assessed with Model for Early Allograft Function (MEAF) Score. Single-center retrospective study evaluating all liver transplants performed at the University Hospital of Udine from January 2010 to August 2020. Patients receiving grafts from DBD donors fed with artificial enteral nutrition in the 48 h prior to organ procurement (EN-group) or who did not (No-EN-group). Caloric debt was calculated using the difference between the calculated caloric needs and the effective calories delivered through enteral nutrition. Livers from EN-group presented a lower mean MEAF score compared to the no-EN-group: 3.39 ± 1.46 versus 4.15 ± 1.51, respectively (p = .04). A positive correlation between caloric debt and the MEAF score was found within the overall population (r = .227, p = .043) as well as in EN-group (r = .306, p = .049). Donor's nutritional intake in the final 48 h before organ procurement correlates with MEAF score, and nutrition probably plays a positive role on the functional recovery of the graft. Large future randomized controlled trials are needed to confirm this preliminary results.

Sections du résumé

BACKGROUND
The role of nutrition in donor after brain deaths (DBDs) has yet to be adequately discussed. The primary aim of this study was to investigate whether the nutritional intake in the 48 h before organ retrieval may play a role on the graft functional recovery assessed with Model for Early Allograft Function (MEAF) Score.
METHODS
Single-center retrospective study evaluating all liver transplants performed at the University Hospital of Udine from January 2010 to August 2020. Patients receiving grafts from DBD donors fed with artificial enteral nutrition in the 48 h prior to organ procurement (EN-group) or who did not (No-EN-group). Caloric debt was calculated using the difference between the calculated caloric needs and the effective calories delivered through enteral nutrition.
RESULTS
Livers from EN-group presented a lower mean MEAF score compared to the no-EN-group: 3.39 ± 1.46 versus 4.15 ± 1.51, respectively (p = .04). A positive correlation between caloric debt and the MEAF score was found within the overall population (r = .227, p = .043) as well as in EN-group (r = .306, p = .049).
CONCLUSIONS
Donor's nutritional intake in the final 48 h before organ procurement correlates with MEAF score, and nutrition probably plays a positive role on the functional recovery of the graft. Large future randomized controlled trials are needed to confirm this preliminary results.

Identifiants

pubmed: 37212369
doi: 10.1111/ctr.15034
doi:

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e15034

Informations de copyright

© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

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Auteurs

Vittorio Cherchi (V)

General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.

Luigi Vetrugno (L)

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy.

Giovanni Terrosu (G)

General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.
Department of Medicine, University of Udine, Udine, Italy.

Cristian Deana (C)

Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.

Marco Ventin (M)

Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.

Victor Zanini (V)

Department of Medicine, University of Udine, Udine, Italy.

Federico Barbariol (F)

Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.

Riccardo Pravisani (R)

Department of Medicine, University of Udine, Udine, Italy.

Tiziana Bove (T)

Department of Medicine, University of Udine, Udine, Italy.
Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.

Andrea Risaliti (A)

Department of Medicine, University of Udine, Udine, Italy.

Dario Lorenzin (D)

General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.

Umberto Baccarani (U)

General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.
Department of Medicine, University of Udine, Udine, Italy.

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