A COMPARISON OF PREOPERATIVE AND POSTOPERATIVE NUTRITIONAL STATES OF LUNG-TRANSPLANT RECIPIENTS

Malnutrition is a documented problem in some types of endstage lung di sease (ESLD). Recently, isolated lung transplants have successfully re versed the respiratory failure of patients suffering from ESLD. In thi s study, we compare the preoperative and postoperative nutritional sta tes of lung transplant recipients using weight-to-height ratios, anthr opometric measurements, subjective global assessment, and biochemical blood values. Patients with emphysema, cystic fibrosis, and other type s of bronchiectasis, but not patients with pulmonary fibrosis or pulmo nary hypertension, were malnourished preoperatively. All groups had no rmal biochemical profiles. Caloric intake of patients with cystic fibr osis and bronchiectasis was increased above predicted basal energy exp enditure levels. By six months to one year postoperatively, all groups of malnourished patients had significantly improved their nutritional status. Emphysema patients improved nutrition by maintaining preopera tive caloric intake levels-however, both cystic fibrosis and bronchiec tasis patients were able to achieve the same goal with significantly d ecreased caloric intakes. We conclude that malnourished ESLD patients receiving isolated lung grafts are able to achieve normal nutrition wi thin one year posttransplant. Since this occurs in all cases with a re duced, or at best maintained, caloric intake, more study is needed to elucidate the factors that contribute to ESLD malnutrition.