Anthropopmetric measurements, hand grip, strenght and bioelectrical impedance analysis in assessment of the nutritional status of ascitic patients with non-alcoholic liver cirrhosis awaiting for liver transplantation

Background: Malnutrition is highly prevalent among patients awaiting liver transplantation. Patients with poor nutritional status before transplant will have more complications and higher mortality postoperatively. Nutritional assessment should be performed in every patient with chronic liver disease awaiting liver transplantation in order to ensure correct and timely nutritional treatment, punctual monitoring pre- and post-transplant, and adequate global prognostic evaluation of the patient. Objective: The aim of the study was to identify a reliable and sensitive panel of measurements for the assessment of malnutrition in patients with chronic liver disease, which could also predict postoperative complications in orthotopic liver transplant recipients.Patients and methods: Twenty-five consecutive hospitalized ascitic patients (18 men, 7 women) with nonalcoholic liver cirrhosis were assessed with anthropometric measurements, handgrip strength and bioelectrical impedance analysis. Result: Comparison between the observed values (measured and calculated) in our 25 patients and the expected values based on percentile distribution showed statistically significant differences for the parameters triceps skinfold thickness, midarm circumference, arm muscle area, fat-free mass, handgrip strength and phase angle. Conclusion: The nutritional evaluation of cirrhotic patients awaiting liver transplant must be as exhaustive as possible. Bioelectrical impedance analysis adds a further parameter to anthropomet- ric measurements and handgrip strength, namely the phase angle, which provides usefulprognostic indications for the selection of candidates for liver transplantation.