Deficiencies in
vitamins A, D, and E have been linked to
night blindness, bone health, and post-
liver transplant reperfusion injury. The aim of this study was to determine the prevalence and predictive factors of fat-soluble
vitamin deficiencies in
liver transplant candidates. We reviewed the medical records of
liver transplant candidates at our center from January 2008 to September 2011. The etiology of
cirrhosis, Model for
End-Stage Liver Disease score, Child-Pugh class, body mass index (BMI), and
vitamin A, vitamin E, and
vitamin 25-OH-D levels were recorded. Patients were excluded for incomplete laboratory data, short gut syndrome,
celiac disease,
pancreatic insufficiency, or prior
liver transplantation. Sixty-three patients were included. The most common etiologies of
liver disease were alcohol (n = 23), hepatitis C virus (n = 19), and
nonalcoholic steatohepatitis (n = 5).
Vitamin A and D deficiencies were noted in 69.8% and 81.0%, respectively. Only 3.2% of the patients were
vitamin E-deficient. There were no documented cases of
night blindness. Twenty-five of the 55 patients with bone density measurements had
osteopenia, and 10 had
osteoporosis. Four patients had vertebral fractures. There was 1 case of posttransplant
reperfusion injury in a patient with
vitamin E deficiency. In a multivariate analysis, there were no statistically significant predictors for
vitamin D deficiency. The Child-Pugh class [odds ratio (OR) = 6.84, 95% confidence interval (CI) = 1.52-30.86, P = 0.01], elevated total
bilirubin level (OR = 44.23, 95% CI = 5.02-389.41, P < 0.001), and elevated BMI (OR = 1.17, 95% CI = 1.00-1.36, P = 0.045) were found to be predictors of
vitamin A deficiency. In conclusion, the majority of
liver disease patients evaluated for
liver transplantation at our center had
vitamin A and D deficiencies. The presence or absence of cholestatic
liver disease did not predict deficiencies, whereas Child-Pugh class,
bilirubin level, and elevated BMI predicted
vitamin A deficiency.