• Ryuichi Yoshida, Takahito Yagi, Hiroshi Sadamori, Hiroaki Matsuda, Susumu Shinoura, Yuzo Umeda, Daisuke Sato, Masashi Utsumi, Takeshi Nagasaka, Nami Okazaki, Ai Date, Ayako Noguchi, Akemi Tanaka, Yuko Hasegawa, Yachiyo Sakamoto, and Toshiyoshi Fujiwara.
• Department of Gastroenterological Surgery Transplant, and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. r9232001@yahoo.co.jp
• J Hepatobiliary Pancreat Sci. 2012 Jul 1;19(4):438-48.

Background/PurposeMalnutrition and metabolic disorder of patients undergoing living donor liver transplantation (LDLT) can affect post-transplant prognosis. The aim of this study was to establish whether perioperative usage of branched-chain amino-acid (BCAA)-enriched nutrients improve metabolic abnormalities of patients undergoing LDLT.MethodsWe designed a randomized pilot study (UMIN registration number; 000004323). Twenty-five consecutive adult elective LDLT recipients were enroled and divided into two groups: the BCAA group (BCAA-enriched nutrients, n = 12) and the control group (standard diet, n = 13). Metabolic and nutritional parameters, including BCAA-to-tyrosine ratio (BTR), retinol binding protein (RBP), and prealbumin were regularly measured from 1 week before to 4 weeks after LDLT. Non-protein respiratory quotient (npRQ) was measured before and 4 weeks after LDLT.ResultsBTR and RBP improved considerably in the BCAA group compared with the controls. npRQ significantly increased from 1 week before LDLT to 4 weeks after LDLT in the BCAA group (0.77 ± 0.05 to 0.84 ± 0.06, P = 0.002), but not in the control group (0.78 ± 0.04 to 0.81 ± 0.05).ConclusionsSupplementation with BCAA-enriched nutrients might improve persistent nutritional and metabolic disorders associated with end-stage liver disease in the early post-transplant period, and consequently shorten the post-transplant catabolic phase after LDLT. A larger multicenter trial is needed to confirm these findings.

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