Fat depletion in liver transplant candidates with autoimmune hepatitis as compared to alcohol-related liver disease

Background: Malnutrition is common in liver transplant candidates.

Aims: Comparative nutritional assessment of candidates for liver transplant.

Patients and methods: Patients assessed for liver transplantation from June 2003 to March 2005 were included. Patient characteristics, underlying liver disease, body weight and height were recorded. Anthropometric measurements included triceps skin fold (TSF) thickness, mid arm circumference (MAC) and mid arm muscle circumference (MAMC).

Results: 77-transplant candidates (male=42) were assessed. Underlying conditions included alcoholic liver disease (n=26), autoimmune hepatitis (n=20, hepatoma (n=8), viral hepatitis (n=9), cryptogenic (n=7) and miscellaneous (n=6). Malnutrition on BMI was identified in 35 (55%) patients (obese=17, overweight=28). TSF measurements identified severe and moderate fat reduction in 7 patients each. MAMC identified severe and moderate muscle mass depletion in 7 and 9 patients respectively. Fat and muscle depletion correlated in 50% of patients. TSF was significantly lower in autoimmune (11.7+1.02) compared to alcoholic liver disease (16.35+1.35), (p=0.046). BMI and MAMC values were not significantly different between groups.

Conclusions: Fat stores are significantly lowered in patients with autoimmune compared to alcoholic transplant candidates. These may reflect nutritional deficiencies in autoimmune group and/or an overlap of metabolic syndromes in alcoholic group. Further studies may help to elaborate these findings.