In patients living with cirrhosis and waiting for liver transplantation (LT), protein-energy malnutrition is the most common complication (> 80%). After LT, nutritional status can worsen rapidly leading to sarcopenia (loss of muscle mass and function). Objectives: 1) Assess longitudinal changes in nutritional risk, muscle function and quality of life in cirrhotic patients awaiting LT. 2) Evaluate the effect of early nutritional supplementation rich in protein, beta-hydroxy-beta-methylbutyrate (HMB) and energy, after LT, on muscle mass and function, nutritional risk and quality of life. Method: A randomized controlled pilot study is conducted including 30 patients going through LT. Muscle mass (CT scan), muscle function (chair stand test), nutritional risk (liver disease undernutrition screening tool) and quality of life (SF-36) are assessed every 3 months before LT, immediately after discharge from hospital and 12 weeks post-LT. At LT, participants are randomized in: (1) intervention group (n=15) receiving standard nutritional care as well as supplements rich in protein, HMB and energy for 12 weeks and (2) control group (n=15) receiving standard nutritional care. Results: Currently, 26 patients awaiting LT are included. One participant was transplanted. The mean age is 51.3 ± 12.9 years. The most common etiology is alcohol (33 %). 84 % of patients are at risk of malnutrition which remain unchanged within up to one year on the waitlist. Muscle function is impaired (18.1 ± 11.0 s vs. 12.6 s in healthy patients; p < 0,001) and decreased with time on waitlist. Regarding quality of life, the score of physical heath (41.8% ± 18.6) and mental health (52.1% ± 25) are below normal. The quality of life tended to decrease over time before LT. Conclusion: The majority of patients waiting for a LT are at risk of malnutrition, display altered muscle function, and a tendency of decreased quality of life. These preliminary data support the need for early nutritional support after LT.
