Manejo nutricional del paciente trasplantado de corazón.

Transplant patients suffer from significant nutritional problems that are secondary to heart failure and its metabolic disorders made worse by the important surgical aggression that they need and by the effect of immune suppressing medications. All these factors justify the establishment of nutritional support in order to reduce complications, avoid mortality, reduce costs, guarantee high quality and improve on outcome. With the objective to review the nutritional management of cardiac transplant patients during the preoperative stage, the postoperative stage in the intensive care unit and the late postoperative period. We reviewed the most important healthcare databases such as Pubmed, Cochrane and Ebsco with the purpose of finding articles about nutrition and heart transplant. We used the Booleans variables. The most common words used for searching were nutrition, cardiac transplant and cardiac starvation. We found 209 articles and selected the ones which responded to the aim of the review. A review article, whose main aspects included the pathophysiology of nutritional disorders in transplant patients, methods for nutritional assessment, preoperative and early and late postoperative treatment, was made. Malnutrition in patients waiting for a heart transplant has been associated with a higher rate of complications and a decreased survival rate after transplantation. It is essential to identify and correct nutritional deficiencies and provide an adequate nutritional support during all phases of transplantation. The main purpose of nutritional support in the immediate post transplant phase is to correct nutritional deficiencies. Prevention is the main objective of chronic nutritional therapy after transplantation. Several metabolic complications such as diabetes mellitus, hypercholesterolemia, obesity, and hypertension are common in patients after transplant. There isn t enough information about the management of nutritional aspects of cardiac transplant patients. In our country the situation is worse. Nowadays, it is extremely necessary to formulate studies about the impact of nutritional phase in the outcome of transplant patients and in patients who undergo cardiovascular surgery in general.