J Paediatr Child Health 1991 Oct;27(5):295-9

Malnutrition in children with chronic liver disease accepted for live
transplantation: clinical profile and effect on outcome

Shepherd RW, Chin SE, Cleghorn GJ, Patrick M, Ong TH, Lynch SV, Balderson G,
Strong R
Queensland Liver Transplant Programme, Royal Children's Hospital, Brisbane,
Queensland, Australia 

Abstract 

The nutritional profiles of 37 children (aged 0.5-14.0 years) with chronic liver
disease at the time of acceptance for orthotopic liver transplantation (OLTP)
have been evaluated using clinical, biochemical and body composition methods.
Nutritional progress while waiting for a donor has been related to outcome,
whether transplanted or not. At the time of acceptance, most children were
underweight (mean standard deviation (s.d.) weight = -1.4 +/- 0.2) and stunted
(mean s.d. height = -2.2 +/- 0.4), had low serum albumin (27/35) and had reduced
body fat and depleted body cell mass (measured by total body potassium--mean %
expected for age = 58 +/- 5%, n = 15). Mean ad libitum nutrient intake was 63
+/- 5% of recommended daily intake (RDI). Those who died while waiting (n = 8)
had significantly lower mean initial s.d. weight compared with those
transplanted. The overall actuarial 1 year survival of those who were
transplanted (mean waiting time = 75 days) was 81% but those who were initially
well nourished (s.d. weight greater than -1.0) had an actuarial 1 year survival
of 100%. There were no significant differences in actuarial survival in
relationship to age, type of transplant (whole liver or segmental), liver
biochemistry or the presence or absence of ascites. Of the total group accepted
for OLTP, whether transplanted or not, the overall 1 year survival for those who
were relatively well nourished was 88% and for those undernourished (initial
s.d. weight less than -1.0) was 38% (P less than 0.003). Declining nutritional
status during the waiting period also adversely affected outcome.(ABSTRACT
TRUNCATED AT 250 WORDS)