ESPEN guideline on clinical nutrition in liver disease
Open accessAbstract
This update of evidence-based guidelines (GL) aims to translate current evidence and expert opinion into recommendations for multidisciplinary teams responsible for the optimal nutritional and metabolic management of adult patients with liver disease. The GL was commissioned and financially supported by ESPEN. Members of the guideline group were selected by ESPEN. We searched for meta-analyses, systematic reviews and single clinical trials based on clinical questions according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing the SIGN method. A total of 85 recommendations were made for the nutritional and metabolic management of patients with acute liver failure, severe alcoholic steatohepatitis, non-alcoholic fatty liver disease, liver cirrhosis, liver surgery and transplantation as well as nutrition associated liver injury distinct from fatty liver disease. The recommendations are preceded by statements covering current knowledge of the underlying pathophysiology and pathobiochemistry as well as pertinent methods for the assessment of nutritional status and body composition.
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Sarcopenia affects 50-60% of individuals with cirrhosis awaiting liver transplantation and is associated with higher rates of wait-list complications, morbidity, and mortality.
“Sarcopenia affects 50-60% of individuals 447 and is associated with higher rates of wait-list complications, morbidity, and mortality.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [447]
The General section’s commentary to recommendations 4 and 5 links muscle loss in wait-listed cirrhosis patients with increased mortality and reports an association between low psoas muscle area and increased morbidity. It also links frailty—not specifically sarcopenia—to complications requiring hospitalization. The guideline does not give the claimed 50–60% prevalence among patients awaiting transplantation. (LLM, conf=0.88)
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References 543 · Cited by 674
Research works printed but not linked: 9
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- Authors
- Plauth, M., Bernal, W., Dasarathy, S., Merli, M., Plank, L. D., Schütz, T., & Bischoff, S. C.
- Affiliations
- Städtisches Klinikum Dessau (DE)
- King's College Hospital (GB)
- Cleveland Clinic (US)
- Sapienza University of Rome (IT)
- University of Auckland (NZ)
- IFB Adiposity Diseases (DE)
- University of Hohenheim (DE)
- Corresponding author
- Plauth, Mathias
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 38
- Issue
- 2
- Pages
- 485-521
- ISSN
- 0261-5614 (ISSN-L)
- PMC
- PMC6686849
- OpenAlex
- W2909512208
- Cited by
- 674
- References
- 543
- Citations by year
- 2026: 79 · 2025: 92 · 2024: 108 · 2023: 92 · 2022: 108 · 2021: 78 · 2020: 84 · 2019: 32 · 2013: 1
- FWCI
- 57.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- NIH (RO1 GM119174, P50 AA024333, R21 AR 71046, UO1 AA0026976, UO1 DK 061732, RO1 DK113196)
- Mikati Family Foundation
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Keywords
- liver disease, dietary management, metabolic control, acute liver failure, alcoholic steatohepatitis, non-alcoholic fatty liver disease, liver cirrhosis, liver transplantation, liver surgery, nutritional assessment, body composition, multidisciplinary care
- MeSH terms
- Europe, Humans, Liver Diseases, Societies, Scientific, Nutritional Support, Evidence-Based Medicine
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