Obesity and organ transplantation: successes, failures, and opportunities.

The increasing rate of societal obesity is also affecting the transplant world through obesity in candidates and donors as well as its posttransplant repercussions. Being overweight and obese has been shown to have significant effects on both short- and long-term complications as well as patient and graft survival. However, much of the comorbidity can be controlled or prevented with careful patient selection and aggressive management.

Nutritional status of patients with alcoholic cirrhosis undergoing liver transplantation: time trends and impact on survival.

Alcoholic cirrhotics evaluated for liver transplantation are frequently malnourished or obese. We analyzed alcoholic cirrhotics undergoing transplantation to examine time trends of nutrition/weight, transplant outcome, and effects of concomitant hepatitis C virus (HCV) and/or hepatocellular carcinoma (HCC). Nutrition and transplant outcomes were reviewed for alcoholic cirrhosis with/without HCV/HCC.

Nutrition in alcoholic liver disease.

Liver disease secondary to alcohol ranges from alcoholic fatty liver disease to acute hepatitis to cirrhotic liver disease. It is imperative that alcohol be discontinued to allow for any potential improvement in liver function, with most benefit being seen in the early stages of the disease. Alcoholic liver disease has a profound effect on nutrient intake, nutrition status, and metabolism, contributing to a high prevalence of malnutrition in this population.

Nutrition and chronic liver disease.

Nutritional abnormalities almost uniformly accompany the metabolic disturbances of severe chronic liver disease and may adversely affect patient well-being and survival, especially surrounding liver transplantation surgery. The exact metabolic alterations responsible for malnutrition and its consequences in these patients have been debated and are a focus of this review. Disturbances in energy production and utilization, as well as macro- and micronutrient metabolism have been appreciated but are not always easily identified or quantifiable.