covid
Buscar en
Endocrinología y Nutrición
Toda la web
Inicio Endocrinología y Nutrición Aspectos nutricionales relacionados con los trasplantes de precursores hematopoy...
Información de la revista
Vol. 53. Núm. 5.
Páginas 315-325 (mayo 2006)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 53. Núm. 5.
Páginas 315-325 (mayo 2006)
Actualización en nutrición clínica
Acceso a texto completo
Aspectos nutricionales relacionados con los trasplantes de precursores hematopoyéticos, pulmonar y hepático
Nutritional aspects related to hematopoietic precursor cell, lung and liver transplantation
Visitas
5903
Alfonso Calañas-Continente
Servicio de Endocrinología y Nutrición. Hospital Universitario Reina Sofía. Córdoba. España
Este artículo ha recibido
Información del artículo

El tratamiento nutricional es un elemento esencial para la cicatrización y el mantenimiento de la salud. Es necesario para conseguir la recuperación del enfermo desnutrido y es coste-efectivo. La desnutrición es frecuente en enfermos en lista de espera para un trasplante y constituye un factor de riesgo de morbilidad postrasplante. Los enfermos en cualquier momento del proceso del trasplante tienen un alto riesgo de desnutrición, por lo que es aconsejable una adecuada y cuidadosa evaluación nutricional que permita identificar precozmente a los candidatos que precisan tratamiento específico. Disponemos en la actualidad de escasos estudios prospectivos, aleatorizados y controlados sobre la importancia del tratamiento nutricional en el trasplante. Este artículo revisa algunos de los aspectos nutricionales más importantes en candidatos a trasplantes de precursores hematopoyéticos, de pulmón y hepático.

Palabras clave:
Estado nutricional
Desnutrición
Evaluación nutricional
Tratamiento nutricional
Nutrición enteral
Nutrición parenteral
Trasplante de células precursoras hematopoyéticas
Trasplante hepático
Trasplante pulmonar

Nutrition plays an essential role in the processes of healing and maintaining health. Nutritional intervention is required in the recovery of malnourished patients and is cost-effective. Malnutrition is common in patients waiting for an organ transplant and represents a risk factor for post-transplant morbidity. Patients at any stage of the transplantation process are at high nutritional risk and should undergo careful nutritional assessment for the early identification of nutritional support requirements. There are only a few prospective, randomized, controlled trials that have investigated the role of nutritional support in organ transplantation. This review discusses some of the most important issues in nutritional support in candidates for hematopoietic stem cell, lung, and liver transplantation.

Key words:
Nutritional status
Malnutrition
Nutritional evaluation
Nutritional support
Enteral nutrition
Parenteral nutrition
Hematopoietic precursor cell transplantation
Liver transplantation
Lung transplantation
El Texto completo está disponible en PDF
Bibliografía
[1.]
U.G. Kyle, Y. Chalandon, R. Miralbell, et al.
Longitudinal follow-up of body composition in hematopoietic stem cell transplant patients.
Bone Marrow Transplant, 35 (2005), pp. 1171-1177
[2.]
P. Horsley, J. Bauer, B. Gallagher.
Poor nutritional status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay.
Bone Marrow Transplant, 35 (2005), pp. 1113-1116
[3.]
C. Tynan, J.M. Hasse.
Current nutrition practices in adult lung transplantation.
Nutr Clin Pract, 19 (2004), pp. 587-596
[4.]
A.J. Calañas-Continente, C. Cerveró Pluvins, E. Muñoz Gomáriz, et al.
Prevalencia de desnutrición en candidatos a trasplante pulmonar.
Nutr Hosp, 17 (2002), pp. 197-203
[5.]
S.M. Levine, E.Y. Sako.
Waiting to make the weight for lung transplantation.
Chest, 121 (2002), pp. 317-320
[6.]
E. Cabré, M.A. Gassull.
Nutrition in liver disease.
Curr Opin Clin Nutr Metab Care, 8 (2005), pp. 545-551
[7.]
F.A. Figueiredo, R. De Mello Perez, M. Kondo.
Effect of liver cirrhosis on body composition: evidence of significant depletion even in mild disease.
J Gastroenterol Hepatol, 20 (2005), pp. 209-216
[8.]
F. Figueiredo, E.R. Dickson, T. Pasha, et al.
Impact of nutritional status on outcomes after liver transplantation.
Transplantation, 70 (2000), pp. 1347-1352
[9.]
M. Vaz, S. Thangam, A. Prabhu, et al.
Maximal voluntary contraction as a functional indicator of adult chronic undernutrition.
Br J Nutr, 76 (1996), pp. 9-15
[10.]
M.R. Alvares-da-Silva, T. Reverbel da Silveira.
Comparison between handgrip strength, subjective global assessment, and prognostic nutritional index in assessing malnutrition and predicting clinical outcome in cirrhotic outpatients.
Nutrition, 21 (2005), pp. 113-117
[11.]
A. Weimann, E.R. Kuse, W.O. Bechstein, et al.
Perioperative parenteral and enteral nutrition for patients undergoing orthotopic liver transplantation. Results of a questionnaire from 16 European transplant units.
Transpl Int, 11 (1998), pp. S289-S291
[12.]
B. Campillo, J.P. Richardet, E. Scherman, et al.
Evaluation of nutritional practice in hospitalized cirrhotic patients: results of a prospective study.
Nutrition, 19 (2003), pp. 515-521
[13.]
F. Manguso, G. D’Ambra, A. Menchise, et al.
Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: a prospective study.
Clin Nutr, 24 (2005), pp. 751-759
[14.]
I. Bilbao, L. Armadans, J.L. Lazaro, et al.
Predictive factors for early mortality following liver transplantation.
Clin Transplant, 17 (2003), pp. 401-411
[15.]
J.G. O’Grady.
Clinical economics review: liver transplantation.
Alim Pharmacol Ther, 11 (1997), pp. S445-S451
[16.]
A. Abad-Lacruz, E. Cabré, F. González-Huix, et al.
Routine tests of renal function, alcoholism, and nutrition improve the prognostic accuracy of Child-Pugh score in nonbleeding advanced cirrhotics.
Am J Gastroenterol, 88 (1993), pp. 382-387
[17.]
M. Shahid, J. Johnson, P. Nightingale, et al.
Nutritional markers in liver allograft recipients.
Transplantation, 79 (2005), pp. 359-362
[18.]
W.I. Bensinger, R. Storb.
Allogeneic peripheral blood stem cell transplantation.
Rev Clin Exp Hematol, 5 (2001), pp. 67-86
[19.]
J.A. Iestra, W.E. Fibbe, A.H. Zwinderman, et al.
Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies.
Bone Marrow Transplant, 23 (1999), pp. 933-939
[20.]
L.M. Arfons, H.M. Lazarus.
Total parenteral nutrition and hematopoietic stem cell transplantation: an expensive placebo?.
Bone Marrow Transplant, 36 (2005), pp. 281-288
[21.]
P.M. Sheean, C. Braunschweig, E. Rich.
The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study.
J Am Diet Assoc, 104 (2004), pp. 1352-1360
[22.]
J.E. Johansson, T. Ekman.
Gastro-intestinal toxicity related to bone marrow transplantation: disruption of the intestinal barrier precedes clinical findings.
Bone Marrow Transplant, 19 (1997), pp. 921-925
[23.]
P. Lenssen, et al.
Hematopoietic stem cell transplantation.
Clinical Nutrition: Enteral and Tube Feeding, 4th ed., pp. 544-558
[24.]
P. Lenssen.
Total parenteral nutrition-induced hyperglycemia in hematopoietic stem cell transplantation.
J Am Diet Assoc, 104 (2004), pp. 1349-1351
[25.]
A.C. Lipkin, P. Lenssen, B.J. Dickson.
Nutrition issues in hematopoietic stem cell transplantation: state of the art.
Nutr Clin Pract, 20 (2005), pp. 423-439
[26.]
S. Roberts, J. Miller, L. Pineiro, et al.
Total parenteral nutrition vs oral diet in autologous hematopoietic cell transplant recipients.
Bone Marrow Transplant, 32 (2003), pp. 715-721
[27.]
C. Scheid, K. Hermann, G. Kremer, et al.
Randomized, doubleblind, controlled study of glycyl-glutamine-dipeptide in the parenteral nutrition of patients with acute leukemia undergoing intensive chemotherapy.
Nutrition, 20 (2004), pp. 249-254
[28.]
S.M. Murray, S. Pindoria.
Nutrition support for bone marrow transplant patients.
Cochrane Database System Rev, (2002),
[29.]
T.R. Ziegler, L.S. Young, K. Benfell, et al.
Clinical and metabolic efficacy of glutamine-supplemented parenteral nutrition after bone marrow transplantation. A randomized, double-blind, controlled study.
Ann Intern Med, 116 (1992), pp. 821-828
[30.]
P.R. Schloerb, M. Amare.
Total parenteral nutrition with glutamine in bone marrow transplantation and other clinical applications.
J Parent Ent Nutr, 17 (1993), pp. 407-413
[31.]
P.M. Anderson, N.K. Ramsay, X.O. Shu, et al.
Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation.
Bone Marrow Transplant, 22 (1998), pp. 339-344
[32.]
N. Piccirillo, S. De Matteis, L. Laurenti, et al.
Glutamine-enriched parenteral nutrition after autologous peripheral blood stem cell transplantation: effects on immune reconstitution and mucositis.
Haematologica, 88 (2003), pp. 192-200
[33.]
V.M. Aquino, A.R. Harvey, J.H. Garvin, et al.
A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study.
Bone Marrow Transplant, 36 (2005), pp. 611-616
[34.]
M.B. Cockerham, B.B. Weinberger, S.B. Lerchie.
Oral glutamine for the prevention of oral mucositis associated with high-dose paclitaxel and melphalan for autologous bone marrow transplantation.
Ann Pharmacother, 34 (2000), pp. 300-303
[35.]
T. Vanegas, Y. Aguilar, A. Valero, et al.
Glutamina oral en pacientes pediátricos oncológicos con altas dosis de metotrexato y doxorubicina. Años 2002-2004.
Rev Venez Oncol, 16 (2004), pp. 207-212
[36.]
R. Pytlik, P. Benes, M. Patorkova, et al.
Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study.
Bone Marrow Transplant, 30 (2002), pp. 953-961
[37.]
G. Cánovas, M. León-Sanz, P. Gómez, et al.
Oral glutamine supplements in autologous hematopoietic transplant: impact on gastrointestinal toxicity and plasma protein levels.
Haematologica, 85 (2000), pp. 1229-1230
[38.]
T.M. Coghlin Dickson, R.M. Wong, R.S. Offrin, et al.
Effect of oral glutamine supplementation during bone marrow transplantation.
J Parent Ent Nutr, 24 (2000), pp. 61-66
[39.]
P.R. Schloerb, B.S. Skikne.
Oral and parenteral glutamine in bone marrow transplantation: a randomized, double-blind study.
J Parent Ent Nutr, 23 (1999), pp. 117-122
[40.]
R. Spielberger, P. Stiff, W. Bensinger, et al.
Palifermin for oral mucositis after intensive therapy for hematologic cancers.
N Engl J Med, 16 (2004), pp. 2590-2598
[41.]
S. Roberts, J. Thompson.
Graft-vs-host disease: nutrition therapy in a challenging condition.
Nutr Clin Pract, 20 (2005), pp. 440-450
[42.]
P. Lenssen, M.E. Sherry, C.L. Cheney, et al.
Prevalence of nutrition-related problems among long-term survivors of allogeneic marrow transplantation.
J Am Diet Assoc, 90 (1990), pp. 835-842
[43.]
D.A. Jacobsohn, J. Margolis, J. Doherty, et al.
Weight loss and malnutrition in patients with chronic graft-versus-host disease.
Bone Marrow Transplant, 29 (2002), pp. 231-236
[44.]
The American Society for Transplant Physicians (ASTP)/American Thoracic Society(ATS)/European Respiratory Society (ERS)/International Society for Heart and Lung Transplantation (ISHLT).
International guidelines for the selection of lung transplant candidates.
Am J Respir Crit Care Med, 158 (1998), pp. 335-339
[45.]
E.I. Lubetkin, D.A. Lipson, H.I. Palevsky, et al.
GI complications after orthotopic lung transplantation.
Am J Gastroenterol, 91 (1996), pp. 2382-2390
[46.]
U.G. Kyle, L. Nicod, C. Raguso, et al.
Fat-free mass change to weight change ratio during refeeding following lung transplantation.
Acta Diabetol, 40 (2003), pp. S165-S167
[47.]
G. Marchesini, R. Marzocchi, M. Noia, et al.
Branched-chain amino acid supplementation in patients with liver diseases.
J Nutr, 135 (2005), pp. S1596-S1601
[48.]
R.T. Poon, W.C. Yu, S.T. Fan, et al.
Long-term oral branched chain amino acids in patients undergoing chemoembolization for hepatocellular carcinoma: a randomized trial.
Aliment Pharmacol Ther, 19 (2004), pp. 779-788
[49.]
I. Nakamura, K. Ochiai, M. Imawari.
Phagocytic function of neutrophils of patients with decompensated liver cirrhosis is restored by oral supplementation of branched-chain amino acids.
Hepatol Res, 29 (2004), pp. 207-211
[50.]
U.J. Tietge, M.J. Bahr, M.P. Manns, et al.
Hepatic amino-acid metabolism in liver cirrhosis and in the long-term course after liver transplantation.
Transpl Int, 16 (2003), pp. 1-8
[51.]
O.E. Owen, V.E. Trapp, G.A. Reichard Jr, et al.
Nature and quantity of fuels consumed in patients with alcoholic cirrhosis.
J Clin Invest, 72 (1983), pp. 1821-1832
[52.]
M. Tsuchiya, I. Sakaida, M. Okamoto, et al.
The effect of a late evening snack in patients with liver cirrhosis.
Hepatol Res, 31 (2005), pp. 95-103
[53.]
Q. Liu, Z.P. Duan, K. Ha da, et al.
Symbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis.
Hepatology, 39 (2004), pp. 1441-1449
[54.]
M. Plauth, A.E. Roske, P. Romaniuk, et al.
Post-feeding hyperammonaemia in patients with transjugular intrahepatic portosystemic shunt and liver cirrhosis: role of small intestinal ammonia release and route of nutrient administration.
Gut, 46 (2000), pp. 849-855
[55.]
E. Cabré, J.M. Hernández-Pérez, L. Fluvià, et al.
Absorption and transport of dietary long-chain fatty acids in cirrhosis: a stable-isotope-tracing study.
Am J Clin Nutr, 81 (2005), pp. 692-701
[56.]
C. Mendenhall, G. Bongiovanni, S. Goldberg, et al.
VA Cooperative Study on Alcoholic Hepatitis. III: Changes in protein-calorie malnutrition associated with 30 days of hospitalization with and without enteral nutritional therapy.
J Par Enter Nutr, 9 (1985), pp. 590-596
[57.]
E. Cabré, F. González-Huix, A. Abad-Lacruz, et al.
Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. A randomized controlled trial.
Gastroenterology, 98 (1990), pp. 715-720
[58.]
P.J. Kearns, H. Young, G. Garcia, et al.
Accelerated improvement of alcoholic liver disease with enteral nutrition.
Gastroenterology, 102 (1992), pp. 200-205
[59.]
V. De Ledinghen, P. Beau, P.R. Mannant, et al.
Early feeding or enteral nutrition in patients with cirrhosis after bleeding from esophageal varices? A randomized controlled study.
Dig Dis Sci, 42 (1997), pp. 536-541
[60.]
L.D. Plank, J.L. McCall, E.J. Gane, et al.
Pre- and postoperative immunonutrition in patients undergoing liver transplantation: a pilot study of safety and efficacy.
Clin Nutr, 24 (2005), pp. 288-296
[61.]
C.S. Hollenbeak, E.J. Alfrey, W.W. Souba.
The effect of surgical site infections on outcomes and resource utilization after liver transplantation.
Surgery, 130 (2001), pp. 388-395
[62.]
N. Rayes, D. Seehofer, T. Theruvath, et al.
Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation – a randomized, double-blind trial.
Am J Transplant, 5 (2005), pp. 125-130
Copyright © 2006. Sociedad Española de Endocrinología y Nutrición
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos