Cochrane · systematic review · CD007605
Nutritional interventions for liver‐transplanted patients
Langer, G, Großmann, K, Fleischer, S, et al. · Cochrane Database of Systematic Reviews · 2012 · Cochrane Library
Hepato-BiliaryAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
54
current version
GRADE rated
54
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 46 · 85.2%Low 8 · 14.8%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Hepatic product (HepaticAid) compared with diet only (without supplement) for adult patients with malnutrition and encephalopathy before and after liver transplantation
Population: adult patients with malnutrition and encephalopathy before and after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐hospitalisation post liver transplantation [event per patient] Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Infections [event per patient] Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Acute rejection [event per patient] Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
New onset of diabetes Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Length of stay in hospital after liver transplantation Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Hepatic encephalopathy related hospitalisation Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision |
Changes in grade of hepatic encephalopathy [grade 0‐4] Hepatic product (HepaticAid) vs diet only (without supplement) | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision |
Standard casein product (Ensure) compared with diet only (without supplement) for adult patients with malnutrition and encephalopathy before and after liver transplantation
Population: adult patients with malnutrition and encephalopathy before and after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐hospitalisation post liver transplantation [event per patient] Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Infections [event per patient] Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Acute rejection [events per patient] Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
New onset of diabetes Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Length of stay in hospital after liver transplantation Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Hepatic encephalopathy related hospitalisation Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Changes in grade of hepatic encephalopathy [grade 0‐4] Standard casein product (Ensure) vs diet only (without supplement) | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Nutritional supplement (500ml) and standard diet compared with standard diet alone for adult patients before and after liver transplantation
Population: adult patients before and after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality during time on waiting list (ITT) Nutritional supplement (500ml) and standard diet vs standard diet alone | OR 0.24 [0.02, 1.37] | 1 study · 82 participants | Very low Downgraded: risk of bias, imprecision |
Six months mortality after liver transplantation (ITT) Nutritional supplement (500ml) and standard diet vs standard diet alone | OR 0.37 [0.06, 1.77] | 1 study · 82 participants | Very low Downgraded: risk of bias, imprecision |
Mild acute rejection episodes (within 6 months after LTx) Nutritional supplement (500ml) and standard diet vs standard diet alone | OR 0.56 [0.19, 1.61] | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Severe acute rejection episodes (within six months after LTx) Nutritional supplement (500ml) and standard diet vs standard diet alone | OR 0.63 [0.22, 1.79] | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Enteral immunonutrion with Supportan compared with enteral nutrition (EN) with Fresubin for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immunological rejection episodes Enteral immunonutrion with Supportan vs enteral nutrition (EN) with Fresubin | no estimate extracted | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Postoperative feeding via nasojejunal tube compared with no postoperative parental nutrition (conventional intravenous electrolyte solution) for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Days in hospital post liver transplantation Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Re‐hospitalisation [events per patient] Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Infections (overall) Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | OR 0.32 [0.04, 1.86] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Infections (bacterial) Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | OR 0.41 [0.03, 3.15] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Infections (viral) Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Intensive care unit length of stay after liver transplantation [hours] Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Time on ventilator [hours until initial extubation] Postoperative feeding via nasojejunal tube vs no postoperative parental nutrition (conventional intravenous electrolyte solution) | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Postoperative enteral nutrition (Osmolite) via nasojejunal tube compared to postoperative parenteral nutrition (PN) for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of hospital stay after liver transplantation [days] Postoperative enteral nutrition (Osmolite) via nasojejunal tube vs postoperative parenteral nutrition (PN) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Days on ventilator Postoperative enteral nutrition (Osmolite) via nasojejunal tube vs postoperative parenteral nutrition (PN) | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Mortality Postoperative enteral nutrition (Osmolite) via nasojejunal tube vs postoperative parenteral nutrition (PN) | OR 0.7 [0.01, 60.29] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Side effects (vomiting, diarrhoea) Postoperative enteral nutrition (Osmolite) via nasojejunal tube vs postoperative parenteral nutrition (PN) | OR 0.68 [0.04, 11.17] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Infection (overall) Postoperative enteral nutrition (Osmolite) via nasojejunal tube vs postoperative parenteral nutrition (PN) | OR 1.07 [0.12, 8.75] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation compared to standard parenteral nutrition for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death (during length of initial hospital stay; ITT) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Infection (ITT) ‐ mycotic infection Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | OR 0.19 [0.02, 1.31] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Infection (ITT) ‐ infection (overall) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | OR 0.35 [0.06, 1.84] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Acute rejection (ITT) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | OR 0.21 [0.004, 2.49] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Length of hospital stay after liver transplantation [days] (ITT) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Intensive care unit length of stay after liver transplantation [days] (ITT) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Days on ventilator (ITT) Enteral nutrition via nasojejunal tube plus intravenous glutamine‐dipeptide supplementation vs standard parenteral nutrition | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Parenteral nutrition with protein, fat, carbohydrates and branched‐chain amino acids compared with 5% dextrose and normal saline for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
1‐year‐survival Parenteral nutrition with protein, fat, carbohydrates and branched‐chain amino acids vs 5% dextrose and normal saline | OR 0.61 [0.05, 5.94] | 1 study · 43 participants | Very low Downgraded: risk of bias |
3‐year‐survival Parenteral nutrition with protein, fat, carbohydrates and branched‐chain amino acids vs 5% dextrose and normal saline | OR 0.93 [0.23, 3.81] | 1 study · 43 participants | Very low Downgraded: risk of bias |
Parenteral nutrition with alanyl‐glutamine, protein, fat, carbohydrates and branched‐chain amino acids compared with 5% dextrose and normal saline for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
1‐year‐survival Parenteral nutrition with alanyl‐glutamine, protein, fat, carbohydrates and branched‐chain amino acids vs 5% dextrose and normal saline | OR 0.29 [5e-04, 4.03] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
3‐year‐survival Parenteral nutrition with alanyl‐glutamine, protein, fat, carbohydrates and branched‐chain amino acids vs 5% dextrose and normal saline | OR 0.76 [0.18, 3.18] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Parenteral nutrition plus branched‐chain‐amino‐acid‐enriched formula compared with standard isotonic intravenous glucose solution for adult patients after liver transplantation
Population: adult patients after liver transplantation.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of hospital stay after liver transplantation [days] Parenteral nutrition plus branched‐chain‐amino‐acid‐enriched formula vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Length of stay in intensive care unit after liver transplantation [days] Parenteral nutrition plus branched‐chain‐amino‐acid‐enriched formula vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Days on ventilator Parenteral nutrition plus branched‐chain‐amino‐acid‐enriched formula vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Mortality [within first 10 weeks after liver transplantation] Parenteral nutrition plus branched‐chain‐amino‐acid‐enriched formula vs standard isotonic intravenous glucose solution | OR 0.46 [0.01, 10.51] | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Standard parenteral nutrition compared with standard isotonic intravenous glucose solution for adult patients after liver transplantation
Population: adult patients after liver transplantation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of stay after liver transplantation [days] Standard parenteral nutrition vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Days on ventilator Standard parenteral nutrition vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Length of hospital stay after liver transplantation [days] Standard parenteral nutrition vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Mortality [within first 10 weeks after liver transplantation] Standard parenteral nutrition vs standard isotonic intravenous glucose solution | no estimate extracted | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Parenteral nutrition with omega‐3 fish oil compared with standard parenteral nutrition for adult patients after liver transplantation
Population: adult patients after liver transplantation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of hospital stay after liver transplantation (days) Parenteral nutrition with omega‐3 fish oil vs standard parenteral nutrition | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Length of stay in intensive care unit after liver transplantation (days) Parenteral nutrition with omega‐3 fish oil vs standard parenteral nutrition | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Acute rejection episodes Parenteral nutrition with omega‐3 fish oil vs standard parenteral nutrition | OR 1 [0.17, 5.77] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Mortality Parenteral nutrition with omega‐3 fish oil vs standard parenteral nutrition | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |