Assessment of the Clinical Impact of a Liver-Specific, BCAA-Enriched Diet in Major Liver Surgery.Krapf, J., et al.
Transplantation Proceedings 2021; 53(2):624-629.
This study aimed to examine the effect of a diet enriched in branched-chain amino-acid (BCAA) in patients following liver transplantation or liver resection surgery.
Participants were randomised to either the BCAA-enriched diet group, or the control group which received standard hospital meals.
57 patients (21 major liver resection patients and 36 patients liver transplant patients).
The primary outcome was general health and well-being. The secondary outcomes were the assessment of liver function, nutritional status (including amino acid profiles), patient survival and subjective well-being.
This single-centre study investigates the use of a high branched-chain amino-acid (BCAA) diet in patients undergoing major hepatic surgery (transplant or resection). 57 patients were randomised to a high BCAA diet or control diet for 14 days post-operatively. The authors report no difference in liver function tests or other clinical outcomes between groups, although patients showed higher satisfaction and compliance with the high BCAA diet. It should be noted that the proportion of patients undergoing transplantation (vs resection) was higher in the control group (73% vs 50%) which may impact the outcomes seen. There are some reporting issues: primary endpoint was defined as quality of life, as assessed by the EORTC QLQ-C30 questionnaire; yet a direct comparison between study groups is not reported. No sample size calculation is reported. There is no consort diagram or clear description of withdrawals from the study, and no demographic table comparing the characteristics of the two groups at baseline.