Branched-Chain Amino Acids and Postoperative Quality of Life in Hepatectomied Patients

Patients with chronic liver disease often reach a state of protein?energy malnutrition, which may influence patient outcomes following surgery and subsequent quality?of?life (QOL). Recent assessments of QOL integrate a biochemical health model with a social science model that is based on the patient’s subjective perception of functioning and wellbeing across a range of physical, mental and social aspects of life. Since most liver neoplasms occur in patients with chronic liver disease, hepatic resection could potentially reduce QOL in these patients by further compromising liver function. Advances in surgical technology and perioperative management have led to hepatic surgical procedures, including liver resection and radiofrequency ablation, being the mainstay of curative treatment for not only hepatocellular carcinoma (HCC), but also metastatic liver tumors. However, hepatic surgery is still associated with postoperative morbidities due to the inevitable deterioration of liver function following a reduction in functioning liver mass. Based on the clinical assessment, dieticians should therefore educate patients and carers about sodium and fluid restriction, and appropriate food choices. In this context, branched?chain amino acid (BCAA) nutritional supplementation improves postoperative QOL over the long term after hepatic resection by restoring and maintaining nutritional status and whole?body kinetics. BCAA may also inhibit carcinogenesis in heavier patients with cirrhosis and play a key role in liver regeneration. Individualized intervention is thus recommended based on patient’s nutritional status.