End-stage liver disease (ESLD) affects thousands of people in the United States annually. Improvements in survival after liver transplantation have broadened the indications for its use as a proven therapy for ESLD, rapidly increasing the number of transplant candidates. However, the number of patients awaiting transplantation far surpasses the donor supply, resulting in lengthy waiting times. During this wait, these patients experience progressive disease-related decompensation that is often accompanied by malnutrition and reduced physical activity. This chronic disease triad can have profound effects on musculoskeletal complications, such as cachexia and osteoporosis. In the absence of proper interventional strategies before transplantation, these complications can intensify after the transplantation, as a result of continued poor nutrition intake, bed rest, and pharmacotherapies. This article discusses levels of physical functioning and nutrition status in both the pre- and post-transplant populations, the risks associated with current levels, and the roles that diet and activity therapies can have to improve outcomes.
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Musculoskeletal Issues| May 01 2002
Roles of Nutrition and Physical Activity in Musculoskeletal Complications Before and After Liver Transplantation
Andrea Q. Vintro, RD, MS ;
From the Department of Physiological Nursing, University of California, San Francisco.
Reprint requests to Andrea Q. Vintro, RD, MS, Liver Transplant Rehab Intervention Project, University of California San Francisco, Department of Physiological Nursing, 2 Koret Way, Room N631, Box 0610, San Francisco, CA 94143-0610 (e-mail: email@example.com).
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Joanne B. Krasnoff, MS ;
AACN Adv Crit Care (2002) 13 (2): 333–347.
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Andrea Q. Vintro, Joanne B. Krasnoff, Patricia Painter; Roles of Nutrition and Physical Activity in Musculoskeletal Complications Before and After Liver Transplantation. AACN Adv Crit Care 1 May 2002; 13 (2): 333–347. doi:
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