Nutritional Counselling and Weight Reduction After Living-Donor Liver Transplantation: A Descriptive Case Report

Abstract

Liver transplantation requires long-term multidisciplinary follow-up, and nutritional care may be incorporated to address body weight and metabolic risk, although intervention evidence in liver transplant recipients remains limited and heterogeneous. The objective was to describe anthropometric, biochemical and patient-reported changes in a liver transplant recipient who followed an individualised nutrition and physical-activity programme alongside standard post-transplant medical care. We describe a 53-year-old man who received a living-donor right-lobe liver transplant for decompensated cirrhosis on 8 November 2022 and attended a nutrition centre on 10 June 2024 while continuing transplant-team follow-up. Pre-counselling laboratory results from 20 May 2024 were compared with results from 25 November 2024. The programme comprised flexible food-based counselling, self-directed aerobic activity and light toning exercises; two commercially available supplements were used concomitantly. Medication information was obtained retrospectively from the patient; he reported no medication or dose changes during the observation period, although complete transplant records, contemporaneous imaging and renal-function data were unavailable. Self-reported adherence was discussed during five follow-up consultations. The report follows the CARE reporting guideline. Body weight decreased from 93 to 88 kg and body mass index from 28.7 to 27.2 kg/m². Several liver-related biochemical markers decreased, although gamma-glutamyl transferase and alkaline phosphatase remained elevated and leukocytosis was present at follow-up. These changes were temporally associated with the observation period but cannot be attributed to nutritional counselling, physical activity or supplement use, because concurrent medical care, graft-related factors and the natural clinical course could not be excluded. This case illustrates the feasibility of incorporating flexible nutritional follow-up into multidisciplinary post-transplant care while emphasising the need for complete clinical documentation and objective follow-up measures.