Evidence map›Paper›PMID 35303370›Full record

SynthesisClinical transplantation2022

The role of preoperative optimization of the nutritional status on the improvement of short-term outcomes after liver transplantation? A review of the literature and expert panel recommendations.

David W Victor, Alberto Zanetto, Aldo J Montano-Loza, Julie K Heimbach, Jennifer Towey, Michael Spiro, Dimitri Aristotle Raptis, Patrizia Burra, ERAS4OLT.org Working Group

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical transplantation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Micronutrient deficiencies in hepatic cirrhosis: Navigating challenges to assessment and implications for clinical management: A narrative review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
    Review
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

David W VictorSherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, Texas, USA.
Alberto ZanettoMultivisceral Transplant Unit/Gastroenterology, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
Aldo J Montano-LozaDivision of Gastroenterology and Liver Unit, University of Alberta, Edmonton, Alberta, Canada.
Julie K HeimbachDivision of Transplant Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Jennifer ToweyDepartment of Dietetics, Queen Elizabeth University Hospital Birmingham, Birmingham, UK.
Michael SpiroDepartment of Anesthesia and Intensive Care Medicine, Royal Free Hospital, London, UK.
Dimitri Aristotle RaptisDivision of Surgery & Interventional Science, University College London, London, UK.
Patrizia BurraMultivisceral Transplant Unit/Gastroenterology, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
ERAS4OLT.org Working Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalnutrition is a known risk factor for postoperative morbidity and mortality in patients awaiting liver transplantation (LT). Malnutrition is a potentially reversible risk factor, though there are no clear guidelines on the best mechanism for an improvement. It also remains unclear if preoperative nutritional interventions have benefits to post-transplant outcomes for transplant recipients.

objectivesPrimary objective: To identify if preoperative optimization of nutritional status is associated with improved short-term outcomes after LT. SECONDARY

objectivesTo determine if preoperative improvement of malnutrition improves short-term outcomes after LT, as well as if weight loss in obese patients affects short-term outcomes after LT. DATA SOURCES: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.

methodsSystematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. POSPERO Protocol ID: CRD42021237450

results3851 records were identified in searching the databases, 3843 records were excluded by not fulfilling eligibility criteria. Seven full-text articles were included for the final analysis of which three were randomized controlled trials, one was prospective observational studies, and three were retrospective observational studies. No appreciable difference in mortality, post-transplant complication rate was noted across the studies. Length of stay (LOS) was noted to be shorter in two observational studies of Vitamin D deficiency in liver transplant patients.

conclusionsWe have made a weak recommendation supporting pre-transplant nutritional supplementation due to possible benefit in reducing LOS as well as the lack of harm (Quality of Evidence low | Grade of Recommendation; Weak). No effective conclusions were reached for the secondary objectives due to the conflicting evidence.

Indexed as

Liver TransplantationNutritional StatusHumansObesityObservational Studies as TopicRetrospective Studiesiron deficiencyliver transplantmalnutritionoptimizationvitamin D

Identifiers

PMID35303370
PMCPMC10078549

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.