Trial reportHepatology (Baltimore, Md.)2024
Reversing malnutrition and low muscle strength with targeted enteral feeding in patients awaiting liver transplant: A randomized controlled trial.
Trial report in Hepatology (Baltimore, Md.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 16 citations in OpenAlex.
- Effect of preoperative oral carbohydrate combined with postoperative early enteral nutrition on the perioperative rehabilitation of patients with colorectal cancer: a multicenter randomized controlled trial.Frontiers in nutrition · 2025Trial
- Article
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- Association between specialized nutrition support and 90-day mortality relative to standard of care in malnourished adults with decompensated cirrhosis: A retrospective cohort study.JPEN. Journal of parenteral and enteral nutrition · 2026Article
- The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.Hepatology communications · 2026Article
- Should nasogastric enteral feeding become a standard escalation to reverse malnutrition in liver transplant candidates?Hepatobiliary surgery and nutrition · 2026Article
- Real-Life Challenges in Assessing Nutritional Status and Quality of Life in Patients with Cirrhosis.Diagnostics (Basel, Switzerland) · 2025Article
- Comparing the performance of 3 sarcopenia definitions for predicting adverse events prior to liver transplant.Hepatology communications · 2025Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMost patients with decompensated cirrhosis fail to meet their nutrition targets. The impact of nasogastric feeding (NGF) on malnutrition in cirrhosis remains unknown. This study aims to assess the impact of pretransplant NGF on pre-liver transplant and post-liver transplant outcomes. APPROACH AND
resultsThis single-center, prospective randomized controlled trial of 55 patients with severe malnutrition and low handgrip strength (HGS) compared a standard high-energy high-protein diet to diet plus supplemental nocturnal NGF while awaiting transplant. The primary outcome was a change in HGS. The median age was 58.5 years (IQR: 51.1-64), median MELD was 24 (20-28.5), and 32 (58%) patients were male. The median duration of NGF was 63.0 days (34.5-127), following which time the median between-group difference in HGS was 3.6 kg (95% CI: 1.7-5.2, p <0.001), an increase of 20% from baseline. Mid-upper-arm circumference, triceps skinfold, and immune function all increased significantly with NGF. Muscle and nutritional parameters continued to improve with increasing duration of feeding. NGF significantly increased daily energy intake between groups by 1285 kcal (95% CI: 860-1677) and protein intake by 51 g (95% CI: 32-71) (both p <0.001). All NGF patients met >100% of their measured nutritional requirements. Posttransplant clinical outcomes were similar between groups.
conclusionsTargeted enteral feeding before liver transplant improves HGS, anthropometry, and immune function in severely malnourished patients with cirrhosis. These findings provide a strong rationale for early consideration of NGF to reverse malnutrition and improve muscle strength. Appropriately powered studies should explore whether NGF can also impact clinically relevant outcomes including pretransplant and posttransplant mortality.
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