Nutritional intake after liver transplant: systematic review and meta-analysis

Lynsey N Spillman, Angela M Madden, Holly Richardson, Fumiaki Imamura, Danielle Jones, Marilyn Hagan, Hong Kai Lim, Holly N Hellawell, Kirsten L Rennie, Linda M Oude Griep, Michael Allison, Simon J Griffin

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Abstract: Cardiovascular disease and its risk factors are prevalent after liver transplant (LT). Most risk factors are modifiable by diet. We aimed to synthesise the literature reporting nutritional intake of liver transplant recipients (LTR) and potential determinants of intake. We performed a systematic review and meta-analyses of studies published up until July 2021 reporting nutritional intake of LTR. Pooled daily mean intakes were 1998 (95% CI 1889, 2108) kcal, 17 (17, 18) % energy from protein, 49 (48, 51) % energy from carbohydrates, 34 (33, 35) % energy from total fat, 10 (7, 13) % energy from saturated fat, and 20 (18, 21) g fibre. Average fruit and vegetable intake ranged from 105 to 418 g/day. Time post-LT, age, sex, continent and year of publication were sources of heter-ogeneity. Nine studies investigated potential determinants of intake, time-post LT, sex and immu-nosuppression medication, with inconclusive results. Energy and protein requirements were not met in the first month post-transplant. After this, energy intake was significantly higher and remained stable over time, with a high fat intake and low intakes of fibre, fruits and vegetables. This suggests that LTR consume a high-energy, low-quality diet long-term and do not adhere to dietary guidelines for cardiovascular disease prevention.
Original languageEnglish
Article number
Pages (from-to)2487
Number of pages18
Issue number11
Publication statusPublished - 26 May 2023


  • Liver transplant; diet; nutrition.


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