Purpose: This review examines the significance of perioperative nutritional management in organ transplantation, with a particular focus on liver transplantation. Organ transplant recipients often experience malnutrition and sarcopenia due to nutritional and metabolic abnormalities associated with organ dysfunction. Because transplantation is a highly invasive procedure, optimizing perioperative nutritional care is critical for improving short-term outcomes and reducing postoperative infection-related mortality.Current concept: Recent clinical investigations have shown that liver transplant recipients, who are frequently afflicted with end-stage liver disease and uncompensated cirrhosis, are particularly vulnerable to protein-energy malnutrition and secondary sarcopenia. Our analysis identified low pre-transplant nutritional status and the absence of preoperative branched-chain amino acid supplementation as independent risk factors for post-transplant sepsis. In response, we developed a customized nutritional therapy protocol that incorporates precise body composition analysis, serial measurements of biochemical markers (including prealbumin, zinc, and the branched-chain amino acid/tyrosine ratio), and targeted supplementation with branched-chain amino acids, zinc acetate, and synbiotics. Early initiation of enteral nutrition coupled with postoperative rehabilitative interventions resulted in improved outcomes. In addition, stratified body composition parameters correlated with survival differences and informed revised transplantation criteria. Conclusion Tailored perioperative nutritional management and rehabilitative strategies are essential for improving early postoperative outcomes in liver transplantation. These findings underscore the need for proactive nutritional assessment and intervention, which may represent a breakthrough in transplant prognosis. Future research should refine nutritional protocols and integrate novel biomarkers, while education and interdisciplinary collaboration remain crucial for enhancing transplant outcomes and reducing complications.

Purpose: This review examines the significance of perioperative nutritional management in organ transplantation, with a particular focus on liver transplantation. Organ transplant recipients often experience malnutrition and sarcopenia due to nutritional and metabolic abnormalities associated with organ dysfunction. Because transplantation is a highly invasive procedure, optimizing perioperative nutritional care is critical for improving short-term outcomes and reducing postoperative infection-related mortality.Current concept: Recent clinical investigations have shown that liver transplant recipients, who are frequently afflicted with end-stage liver disease and uncompensated cirrhosis, are particularly vulnerable to protein-energy malnutrition and secondary sarcopenia. Our analysis identified low pre-transplant nutritional status and the absence of preoperative branched-chain amino acid supplementation as independent risk factors for post-transplant sepsis. In response, we developed a customized nutritional therapy protocol that incorporates precise body composition analysis, serial measurements of biochemical markers (including prealbumin, zinc, and the branched-chain amino acid/tyrosine ratio), and targeted supplementation with branched-chain amino acids, zinc acetate, and synbiotics. Early initiation of enteral nutrition coupled with postoperative rehabilitative interventions resulted in improved outcomes. In addition, stratified body composition parameters correlated with survival differences and informed revised transplantation criteria. Conclusion Tailored perioperative nutritional management and rehabilitative strategies are essential for improving early postoperative outcomes in liver transplantation. These findings underscore the need for proactive nutritional assessment and intervention, which may represent a breakthrough in transplant prognosis. Future research should refine nutritional protocols and integrate novel biomarkers, while education and interdisciplinary collaboration remain crucial for enhancing transplant outcomes and reducing complications.

Purpose: This review examines the significance of perioperative nutritional management in organ transplantation, with a particular focus on liver transplantation. Organ transplant recipients often experience malnutrition and sarcopenia due to nutritional and metabolic abnormalities associated with organ dysfunction. Because transplantation is a highly invasive procedure, optimizing perioperative nutritional care is critical for improving short-term outcomes and reducing postoperative infection-related mortality.Current concept: Recent clinical investigations have shown that liver transplant recipients, who are frequently afflicted with end-stage liver disease and uncompensated cirrhosis, are particularly vulnerable to protein-energy malnutrition and secondary sarcopenia. Our analysis identified low pre-transplant nutritional status and the absence of preoperative branched-chain amino acid supplementation as independent risk factors for post-transplant sepsis. In response, we developed a customized nutritional therapy protocol that incorporates precise body composition analysis, serial measurements of biochemical markers (including prealbumin, zinc, and the branched-chain amino acid/tyrosine ratio), and targeted supplementation with branched-chain amino acids, zinc acetate, and synbiotics. Early initiation of enteral nutrition coupled with postoperative rehabilitative interventions resulted in improved outcomes. In addition, stratified body composition parameters correlated with survival differences and informed revised transplantation criteria. Conclusion Tailored perioperative nutritional management and rehabilitative strategies are essential for improving early postoperative outcomes in liver transplantation. These findings underscore the need for proactive nutritional assessment and intervention, which may represent a breakthrough in transplant prognosis. Future research should refine nutritional protocols and integrate novel biomarkers, while education and interdisciplinary collaboration remain crucial for enhancing transplant outcomes and reducing complications.

Purpose: This review examines the significance of perioperative nutritional management in organ transplantation, with a particular focus on liver transplantation. Organ transplant recipients often experience malnutrition and sarcopenia due to nutritional and metabolic abnormalities associated with organ dysfunction. Because transplantation is a highly invasive procedure, optimizing perioperative nutritional care is critical for improving short-term outcomes and reducing postoperative infection-related mortality.Current concept: Recent clinical investigations have shown that liver transplant recipients, who are frequently afflicted with end-stage liver disease and uncompensated cirrhosis, are particularly vulnerable to protein-energy malnutrition and secondary sarcopenia. Our analysis identified low pre-transplant nutritional status and the absence of preoperative branched-chain amino acid supplementation as independent risk factors for post-transplant sepsis. In response, we developed a customized nutritional therapy protocol that incorporates precise body composition analysis, serial measurements of biochemical markers (including prealbumin, zinc, and the branched-chain amino acid/tyrosine ratio), and targeted supplementation with branched-chain amino acids, zinc acetate, and synbiotics. Early initiation of enteral nutrition coupled with postoperative rehabilitative interventions resulted in improved outcomes. In addition, stratified body composition parameters correlated with survival differences and informed revised transplantation criteria. Conclusion Tailored perioperative nutritional management and rehabilitative strategies are essential for improving early postoperative outcomes in liver transplantation. These findings underscore the need for proactive nutritional assessment and intervention, which may represent a breakthrough in transplant prognosis. Future research should refine nutritional protocols and integrate novel biomarkers, while education and interdisciplinary collaboration remain crucial for enhancing transplant outcomes and reducing complications.

Purpose: This review examines the significance of perioperative nutritional management in organ transplantation, with a particular focus on liver transplantation. Organ transplant recipients often experience malnutrition and sarcopenia due to nutritional and metabolic abnormalities associated with organ dysfunction. Because transplantation is a highly invasive procedure, optimizing perioperative nutritional care is critical for improving short-term outcomes and reducing postoperative infection-related mortality.Current concept: Recent clinical investigations have shown that liver transplant recipients, who are frequently afflicted with end-stage liver disease and uncompensated cirrhosis, are particularly vulnerable to protein-energy malnutrition and secondary sarcopenia. Our analysis identified low pre-transplant nutritional status and the absence of preoperative branched-chain amino acid supplementation as independent risk factors for post-transplant sepsis. In response, we developed a customized nutritional therapy protocol that incorporates precise body composition analysis, serial measurements of biochemical markers (including prealbumin, zinc, and the branched-chain amino acid/tyrosine ratio), and targeted supplementation with branched-chain amino acids, zinc acetate, and synbiotics. Early initiation of enteral nutrition coupled with postoperative rehabilitative interventions resulted in improved outcomes. In addition, stratified body composition parameters correlated with survival differences and informed revised transplantation criteria. Conclusion Tailored perioperative nutritional management and rehabilitative strategies are essential for improving early postoperative outcomes in liver transplantation. These findings underscore the need for proactive nutritional assessment and intervention, which may represent a breakthrough in transplant prognosis. Future research should refine nutritional protocols and integrate novel biomarkers, while education and interdisciplinary collaboration remain crucial for enhancing transplant outcomes and reducing complications.

A male pedestrian in his 30’s was hit by a car and immediately taken to hospital by ambulance. On arrival, his blood pressure was 83/64 mmHg and his heart rate was 140 beats/min. Computed tomography showed extravasation of contrast medium from the lateral segment of the liver. Given the exacerbation caused by hypotension, an emergency laparotomy was performed. Temporary hemostasis was achieved by packing with gauze and a subsequent transcatheter arterial embolization. At the 2nd laparotomy, a small amount of active bleeding from the injury site was noted; therefore, an emergency lateral segmentectomy was performed. The postoperative course was uneventful and he was discharged home 8 days later. The pathology of the liver specimen revealed that a 2.5 cm hepatic hemangioma was the cause of bleeding. Traumatic rupture of hepatic hemangiomas is rare, and most reported cases are of giant hemangiomas. Our case demonstrated that even a small hemangioma can elicit life-threatening bleeding in blunt abdominal trauma.