Nutritional aspects of prehabilitation in adults with cirrhosis awaiting liver transplant.

Multidimensional prehabilitation programs have been proposed as a safe intervention in adults awaiting LT but the nutritional pillar of prehabilitation has been understudied.

已经提出了多维度的术前康复计划作为成人等待LT的安全干预措施，但术前康复的营养支柱尚未得到充分研究。

This review summarizes the nutritional recommendations for prehabilitation for individuals with cirrhosis awaiting LT.

本综述总结了等待肝移植的肝硬化患者营养预康复的建议。

Three major aspects of nutritional prehabilitation are discussed: (1) Assess: Evaluate nutritional status and assess for malnutrition, sarcopenia, and frailty to guide the nutritional prehabilitation intervention intensity, increasing across universal, targeted, and specialist levels; (2) Intervene: Prescribe a nutritional prehabilitation intervention to meet established nutrition guidelines in cirrhosis with a targeted focus on improving nutritional status and muscle health; (3) Reassess: Follow-up based on the required intensity of nutritional care with as needed intervention adjustment.

讨论了营养预康复的三个主要方面：（1）评估：评估营养状况并检查营养不良、肌肉消瘦和虚弱，以指导营养预康复干预的强度，强度从普遍、针对性到专家级别递增；

Topics covered in the review include nutritional care levels for prehabilitation, energy prescriptions across body mass index strata, detailed considerations around protein intake (amount, distribution, and quality), carbohydrate and fat intake, other nutritional considerations, and the potential role of dietary supplements and nutraceuticals.

综述涵盖的内容包括术前康复营养护理水平、不同体重指数下的能量处方、蛋白质摄入量、分布和质量的详细考虑、碳水化合物和脂肪摄入、其他营养考虑以及膳食补充剂和营养保健品的潜在作用。

Future research is warranted to more accurately evaluate energy needs, evaluate emerging dietary supplementation strategies, and establish the role of nutraceuticals alongside food-based interventions.

未来的研究需要更准确地评估能量需求，评估新兴的膳食补充策略，并确定营养保健品与基于食物的干预措施相结合的作用。

While the general principles of nutritional prehabilitation are ready for immediate application, future large-scale randomized controlled trials in this space will help to quantify the benefit that can be gained by transitioning the LT approach from passive "transplant waitlist time" to active "transplant preparation time."

尽管营养预康复的一般原则已经准备好立即应用，但未来在这个领域的大型随机对照试验将有助于量化通过将LT方法从被动的‘移植等待时间’转变为积极的‘移植准备时间’所获得的益处。