Dietitians' practices and perspectives on nutrition priorities for liver transplant recipients

作者：Murray Eryn M^*; McCoy Simone M; Campbell Katrina L; Hickman Ingrid J

来源：Nutrition and Dietetics, 2014, 71(2): 86-91.

DOI：10.1111/1747-0080.12079

• diet
• dietetic
• obesity
• service
• transplant
• weight

Aim: To describe current practice and priorities of dietitians during the acute (<= 3 months) and long-term (>= 6 months) management of liver transplant recipients.
Methods: Ten liver transplant dietitians (10/14, 71%) in Australia, New Zealand, UK and USA responded to an online survey. The survey graded nutrition priorities on a Likert scale, recorded barriers to service delivery and workforce allocation for nutrition services (ratio of full-time equivalent: annual transplant rate).
Results: Just over half (n = 6, 60%) reported routine dietary assessment post-liver transplant. The majority (90%, n = 9) also provide initial dietary education in the acute setting. Thirty percent (n = 3) routinely provide ongoing acute follow up; however, no sites provide routine follow up after 6 months. Dietitian-to-transplant patient ratios demonstrated a broad range of resource allocation across sites 1: 244 (1: 39-1: 1410). 70% (n = 7) reported lack of funding as a major barrier. Protein and energy requirements (n = 10, 100%) were identified as the main clinical focus in the acute period. Prevention of post-transplant weight gain and diabetes were identified as priority areas during the acute period by 60% of respondents (n = 6) and long-term management by all respondents (n = 10, 100%).
Conclusion: This international survey identified inconsistent resourcing of nutrition services post-liver transplantation, with lack of funding the main barrier to providing long-term care. While the majority of liver transplant dietitians prioritise prevention of excessive weight gain, long-term follow up is limited. Further research is needed to investigate the optimal management of liver transplant recipients.

• 出版日期2014-6