Effects of branched‐chain amino acids–enriched nutrient support for patients undergoing liver resection for hepatocellular carcinoma

Abstract

This study strongly suggests that perioperative supplementation of a branched-chain amino acid-enriched nutrient-mixture is clinically beneficial in reducing the morbidity associated with postoperative complications and in shortening the duration of hospitalization of patients with chronic liver disease who undergo liver resection for HCC.

Modulation of extracellular matrix by nutritional hepatotrophic factors in thioacetamide-induced liver cirrhosis in the rat

“…The HF-treated rats showed partial restoration of the hepatic parenchyma: the lobular architecture was closer to that found in healthy animals, with an easier identification of the portal vessels and centrolobular veins. Although the effect of some components of the HF solution has been previously studied (2)(3)(4)(5), the amino acids and other nutritional components seem to act synergistically, providing the additional material and stimulus necessary to the rebuilding of the liver architecture disturbed by the cirrhotic process (6).…”

“…In fact, liver proliferation can be modulated by dietary factors that interfere with hepatic regeneration. Studies dealing with nutritional modulation of hepatic regeneration and growth by stimulation of hepatocyte proliferation with hepatotrophic factors (HF) found in food have been published (2)(3)(4)(5)(6). Hepatic mass and DNA increase associated with reduction of the fibrotic fraction in the extracellular matrix was observed after 10 days of intraperitoneal treatment with HF in normal rats.…”

“…E-mail: rrguerra@usp.br Liver transplantation is the only definitive treatment in some cases of human chronic cirrhosis (1). Nutritional support has been shown to be helpful in some liver diseases (2,3). In fact, liver proliferation can be modulated by dietary factors that interfere with hepatic regeneration.…”

Evidence-based clinical practice guidelines for liver cirrhosis 2015

“…Perioperative supplementation with a BCAA-enriched nutrient mixture reduces the morbidity associated with postoperative complications, preserves serum albumin levels, and shortens the duration of hospitalization of patients undergoing liver resection for HCC [12]. The annual changes in the Model for End-Stage Liver Disease (MELD) score, Child-Pugh score, and asialoscintigraphic clearance index were smaller and the incidence of ascites was lower in cirrhotic patients taking BCAA granules, which suggests that early interventional oral BCAA administration may prolong the liver transplant waiting period [13].…”

Early recovery pathway for hepatectomy: data-driven liver resection care and recovery

“…In fact, there is relatively weak evidence to support the practice of carbohydrate loading in advance of surgery, but afterward it is clear that early introduction of enteral nutrition can reduce overall morbidity and specifically septic complications (39)(40)(41)(42). Following hepatic resections, patients are in a catabolic state characterized by glucose and electrolyte imbalances mitigated by increased metabolic demand (43).…”