Trials demonstrating benefit of nutritional intervention
| Type of nutritional support | Authors | Intervention | Main outcome measure |
|---|---|---|---|
| Enteral | Cabre et al34 | RCT comparing tube feeding with standard diet (2115 kcal/day) in patients with severe malnutrition | Significant reduction in mortality as inpatient (12% vs 47%) |
| Hirsch et al33 | 1000 kcal (34 g protein) daily supplement compared with placebo | Reduction in hospitalisation | |
| Bunout et al44 | Intake of 50 kcal/kg/day and 1.5 g protein/kg/day compared with standard diet | Non-significant reduction in mortality | |
| Kearns et al35 | Intake of 167 kcal/kg/day and 1.5 g protein/kg/day | Improvement of surrogate markers of liver disease, no significant reductions in primary end points | |
| Parenteral | Wicks et al45 | Comparison between enteral and parenteral feeding immediately post-OLT | No difference between two groups |
| Branch chain amino acid | Muto et al25 | BCAA (12 g/day for 2 years) oral supplement RCT | Significant reduction in primary outcome (mortality, HCC, variceal bleed and progression of disease) |
| Marchesini et al24 | BCAA oral supplement RCT | Significant reduction in hospital admissions and surrogate markers of nutrition |
BCAA, branched chain amino acid; HCC, hepatocellular carcinoma; OLT, orthotopic liver transplantation; RCT, randomised controlled trial.