Early Enteral Feeding After Living Donor Liver Transplantation Prevents Infectious Complications: A Prospective Pilot Study.
Kim JM, Joh J, et al.Medicine 2015; 94(44): e1771.
Aims
To analyse the nutritional parameters and short-term clinical outcomes of early enteral feeding in patients after living donor liver transplantation (LDLT).
Interventions
Participants were randomized to receive either enteral formula via nasointestinal feeding tubes (enteral feeding group), or maintenance on intravenous fluid until oral diets were initiated (control group).
Participants
36 patients who underwent elective LDLT aged 36-64 years
Outcomes
The primary outcome measured was occurrence of infectious complications. Secondary outcomes were total length of stay, improvement in nutritional status, episodes of acute rejection, bile duct complications, graft failure, and mortality.
Follow-up
3 months
CET Conclusions
This study randomised recipients of live donor liver transplants to receive enteral nutrition via NG tube or not. It is unclear however whether or not patients in the control arm received any nutritional supplements by mouth. The authors state that an NG tube was inserted "several days" after surgery, yet it is not reported whether or not any patients were able to maintain their intake orally before an NG tube was inserted, which seems likely as the control group were eating by 4 days on average. The study was rather small and therefore did not find any difference in most of the outcomes measured, including surrogate markers of nutritional status (such as BMI, mid-arm circumference, triceps skin fold and so on). Interestingly however the was a rather large difference in bacterial infections (29% study versus 63% control), and this highlights a very high baseline risk if correct.
Data analysis
Per protocol analysis
Trial registration
None