[Evaluation of the nutritional status and physical performance in candidates to liver transplantation].

Objective: To evaluate the physical capacity and nutritional status of patients before orthotopic liver transplantation (OLT) and to correlate these parameters to the severity of liver function.

Methods: Thirty-two patients before OTL were classified as Child-Pugh A (25%), B (22%) and C (53%). Physical capacity was analyzed by the quadriceps and ankle strength, balance, coordination, gait velocity, 6 minute walk test, get up and go test, Barthel and Karnofsky indexes. Nutritional status was evaluated by using Mendenhall score and Blackburn classification.

Results: Quadriceps weakness was found in 32% of the patients. Impaired balance and coordination were detected in 34.8% and 15.6% of the patients. Low physical performance was found in 72.5% of the patients (6 min walk test: 31.6% severely; 40.9% moderately impaired) and 43.8% required considerable assistance when the Karnofsky index was applied. Malnutrition was found in 62.5% of the patients (34.37% moderately and severely malnourished and 28.13% mildly malnourished). Chi-square analysis showed no association between Child-Pugh classification and nutritional status, the 6 min walk test and Karnofsky index. The association between the two functional tests was statistically significant (p<0.001).

Conclusion: The results show that physical impairment and nutritional deficit were highly prevalent in the patients studied, independent of the degree of hepatic dysfunction evaluated by the traditional Child-Pugh classification.