ABSTRACT
Malnutrition is a common nding in liver cirrhosis, and protein energy malnutrition may be present in 20% of patients with well-compensated disease and in more than 60% of patients with severe liver insufciency.1 See Table 3.1 for general facts regarding malnutrition in liver cirrhosis. Many mechanisms are involved in the pathogenesis of malnutrition, and the two main factors are insufcient dietary intake and anorexia.2 In patients with end-stage liver disease, protein-calorie malnutrition
is almost universal. The presence of protein-calorie malnutrition has been associated with adverse outcomes in patient and graft survival after liver transplantation.1 The association of protein-calorie malnutrition with adverse outcomes has increased the importance of identifying reliable and cost-effective methods for assessing the nutritional status of patients with end-stage liver disease. Unfortunately, traditional methods of measuring nutritional status (including plasma levels of hepatically synthesized plasma proteins, total lymphocyte count, delayed type hypersensitivity, and anthropometrics) are confounded by the changes in metabolism, body composition, and immune function that occur in liver disease independent of nutritional status.
