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Objective Liver transplant procedure represents a therapeutic intervention which greatly improves the prognosis of patients with chronic illnesses and normalizes clinical parameters of the failing organ. However, preoperative undernourished state, stress, protein catabolism, postoperative complications and period of intentional deprivation of food in the immediate post- operative period all have a significant impact on the success rate of transplant procedure itself. The aim of this study was to determine the nutritional status of patients undergoing liver transplantation. Of particular interest was the composition of fatty acids in the serum of patients and the possible lack of essential polyunsaturated fatty acids (PUFA). Materials and Methods Fifty patients with liver transplant were included in the study. Blood samples were collected on day 1 (before transplantation), and again one month after transplantation. In collected blood samples basic biochemical parameters were monitored. Total lipids were extracted with the solvent mixture (chloroform:methanol), and after trans- esterification with methanolic HCl, the composition of fatty acids was analysed by gas chromatography. All participants gave their written consent. Results The serum analysis of post-transplant patients revealed increased total lipid concentration, as well as mass concentration of fatty acids, while the ratio of fatty acids did not significantly change. The exception was an increase in the ratio of oleic acid (OA, C18:1n-9) and a decrease in linolenic acid (LNA, C18:3n-3) ratio, which resulted in the increased ratio of n- 6/n-3 polyunsaturated fatty acids (PUFA). These results indicate the lack of essential linolenic acid due to inappropriate nutritional intake. The increased ratio of oleic acid is most probably a result of increased endogenic synthesis and compensatory mechanism by which organism fulfils the pool of unsaturated fatty acids. However, an increased n-6/n-3 PUFA ratio is not desirable because it promotes the formation of pro- inflammatory eicosanoids derived from arachidonic (C20:4n-6) acid. Conclusions The study results point to the insufficient nutritional n-3 PUFA intake in patients after liver transplantation. They can serve as the basis for changing postoperative algorithms. Better nutritional planning and n-3 PUFA supplementation could improve the graft survival, decrease the time of hospitalization and recovery, and thus ultimately also decrease the overall costs of medical treatment. |
