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DEFICIENCIES OF MICRONUTRIENTS IN POTENTIAL LIVER TRANSPLANT CANDIDATES: A CROSS-SECTIONAL STUDY
MANESH KUMAR, ZAGHAM ABBAS, DARAYUS P GAZDER, SHAMM NAZR, SANA MAQBOOL, MUHAMMAD A QADEER
Euroasian Journal of Hepato-Gastroenterology - 2025;15(1):24-28

Background: Decompensated liver disease is a debilitating condition often accompanied by significant micro- and macronutrient deficiencies, which can worsen prognosis and complicate treatment, particularly in potential liver transplant candidates. Objective: We aimed to identify nutritional deficiencies in patients with decompensated chronic liver disease (CLD), who are potential recipients for liver transplantation. Materials and methods: This cross-sectional, single-center prospective study included consecutive patients. Blood tests were performed to measure levels of key micronutrients, including vitamin D3, zinc, calcium, magnesium, phosphorus, iron, folic acid, and vitamin B12. Nutrient deficiencies were compared in patients with a model for end-stage liver disease (MELD) score ≥15 or less, and Child-Pugh class of B and C. Results: The cohort comprised a total of 116 patients, 79 (68.1%) males and 37 (31.9%) females. Sixty-nine patients (59.5%) were classified as Child-Pugh class B and 47 patients (40.5%) as Child-Pugh class C, and 71 (61.2%) patients had an MELD score of ≥15. The primary etiologies of CLD were hepatitis C [49 (42.2%)], non-alcoholic fatty liver disease [30 (25.9%)], alcoholic liver disease [20 (17.2%)], hepatitis B [11 (9.5%)], and autoimmune liver disease [6 (5.2%)]. The study identified higher frequencies of deficiencies in zinc (89.7%), vitamin D3 (deficient 62.1%, insufficient 23.3%), calcium (18.1%), folate (15.5%), magnesium (14.7%), iron (13.8%), phosphorus (10.3%), and vitamin B12 (5.2%) across the entire cohort. Vitamin D and magnesium deficiencies became more frequent in Child-Pugh class C compared to B (p = 0.001 and p = 0.006) and MELD score ≥15 (p = 0.001 and p ≤ 0.001). Conclusion: The high prevalence of deficiencies of crucial micronutrients, such as vitamin D3, zinc, magnesium, and iron highlighted the necessity of comprehensive assessments of nutrition and targeted intervention in patients with decompensated CLD. Effective management of micronutrient levels could potentially reduce complications, improve patient health, and enhance outcomes in these potential liver transplant candidates.

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