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Nutritional Support Team Approach Decreases the In-Hospital Mortality Rate after Deceased Donor Liver Transplantation
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Sang-Oh Yun, Jong Man Kim, Sangjin Kim, Jinsoo Rhu, Hyun Jung Kim, Soo Hyun Park, Hyo Jung Park, Eunmi Gil, Wonseok Kang, Gyu-Seong Choi, Won Hyuck Chang, Jeong-Meen Seo, Jae-Won Joh
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Surg Metab Nutr 2020;11(1):7-11. Published online June 30, 2020
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DOI: https://doi.org/10.18858/smn.2020.11.1.7
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Abstract
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- Purpose: This study compared the mortality rates between a period of time without employing a nutritional support team (NST) and a period of time with an NST.
Materials and Methods: Forty-six patients underwent adult deceased donor liver transplantation (DDLT) in 2016, and their medical records were prospectively collected. All the donor recipients underwent routine enteral feeding after liver transplantation. An NST cared for twenty-one patients after September 2016. The NST consisted of transplant surgeons, hepatologists, a critical care team, a rehabilitation team, dietitians, pharmacists, and nurses. We defined the patients within the time period without an NST as the control group and those patients within the time period with an NST as the case group. Results: There were no statistically significant differences in baseline or perioperative characteristics between the two groups. The median model for the end-stage liver disease (MELD) score was 36 (range: 21∼40) for the control group and 36 (range: 23∼40) for the case group (P=0.596). The 30-day mortality rate was 24.0% (6/25) for the control group, but it was 4.8% (1/20) for the case group. The patient survival rates at 1-year and 2-year were 68.0% and 64.0% in the control group and 85.7% and 81.0% in the case group, respectively. However, there were no statistically significant differences of the 30-day mortality rate and 1∼2 year patient survival rate between the two groups. Conclusion: The present study suggests that an NST should be required to prevent 30-day mortality and increase patient survival of adult DDLT patients with a high MELD score.
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