Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (31): 5873-5878.doi: 10.3969/j.issn.1673-8225.2011.31.042

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Clinical observation of enteral immunonutrition in patients undergoing liver transplantation

Zhao De-fang1, Zhang Ke2, Lang Ren3, Zhao Li-jun4   

  1. 1Department of Hepatobiliary Surgery, Affiliated Hospital of Inner Mongolia Medical College, Hohhot  010059, Inner Mongolia Autonomous Region, China
    2Department of General Surgery, Beijing Ditan Hospital, Beijing  100011, China
    3Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Beijing  100021, China
    4Department of General Surgery, Hebei United University Medical School, Tangshan  063000, Hebei Province, China
  • Received:2011-03-06 Revised:2011-06-11 Online:2011-07-30 Published:2011-07-30
  • Contact: Zhang Ke, Associate chief physician, Department of General Surgery, Beijing Ditan Hospital, Beijing 100011, China zhangke302@sina.com
  • About author:Zhao De-fang☆, Doctor, Associate chief physician, Department of Hepatobiliary Surgery, Affiliated Hospital of Inner Mongolia Medical College, Hohhot 010059, Inner Mongolia Autonomous Region, China hostmanabc@hotmail.com

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Abstract:

BACKGROUND: Immunonutrition therapy can increase the synthesis of proteins with shorten half-life, regulate the local and whole body cytokines production, make the intestinal structure and functional integrity, up-regulate the immunity-inhibiting after operation through the improvement of cellular immune function. It has been proved that the appropriate nutritional therapy during perioperative period can improve the patients’ immune function; however, enteral immunonutrition (EIN) in patients undergoing liver transplantation is rarely reported.
OBJECTIVE: To evaluate the safety and effectiveness of EIN therapy during liver transplantation.
METHODS: Eighty-four patients undertaking liver transplantation were randomly divided into two groups, namely EIN group and regular enteral nutrition (EN) group (given EIN and common EN respectively). The liver function, cellular immunity, humoral immunity, infection and the incidence of rejection were monitored in order to compare the therapeutic efficacy of two kinds of nutrition therapies.
RESULTS AND CONCLUSION: The serum prealbumin and cholinesterase levels were impressively higher in the EIN group at 1 day before operation than before nutritional therapy. The expressions of CD3+ and CD4+ were significantly higher in the EIN group than the EN group at 1 day before operation (P < 0.05). The recovery of cell immunity was delayed 1 week in the EN group as compared with the EIN group; at 1-28 days after operation, IgA level was higher in the EIN group than in the EN group  (P < 0.05). No increase in the incidence of infections occurred in the two groups. The results suggest that the EIN can improve the cell immunity and humoral immunity with a better effect than the EN. The EIN therapy is necessary for the rehabilitation of patients undergoing liver transplantation at the perioperative stage.

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