Cancer Support India

Key Summary:

Recipients had twice the adjusted odds of airflow limitation versus controls.
PRISm affected 23.8% of recipients, compared with 11.8% of controls.
Prior pulmonary infection was associated with airflow limitation after transplantation.

LIVER transplant recipients had poorer lung function and more dyspnea than matched adults in a nationwide study.

The findings indicate that chronic pulmonary abnormalities may represent an under-recognized comorbidity following liver transplantation, extending concerns beyond the established burden of acute pulmonary infections.

Lung Function in Liver Transplant Recipients

Investigators compared 512 adult liver transplant recipients from a Danish nationwide comorbidity study with 2,010 age and sex matched participants from a general population cohort. Participants underwent spirometry to assess forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), airflow limitation, and preserved ratio impaired spirometry (PRISm).

The researchers also assessed patient reported breathlessness using the modified Medical Research Council dyspnea scale.

Airflow limitation was identified in 10.7% of liver transplant recipients and 7.1% of controls. The difference was statistically significant. PRISm was approximately twice as common among recipients, affecting 23.8%, compared with 11.8% of the control group.

Associations Persist After Adjustment

After adjustment for age, sex, ethnicity, cumulative smoking exposure, and educational status, living with a transplanted liver was associated with more than twice the odds of airflow limitation. The adjusted odds ratio was 2.06.

The association was stronger for PRISm, with liver transplant recipients having nearly three times the adjusted odds of this spirometric pattern compared with controls.

Adjusted analyses also found that recipients had an FEV1 that was 363 mL lower and an FVC that was 549 mL lower. Both findings indicate clinically relevant differences in measured lung function that were not explained by the demographic and smoking related factors included in the models.

Pulmonary Infection and Dyspnea

Liver transplant recipients reported more frequent and more severe dyspnea than matched controls. Among recipients, a previous pulmonary infection was associated with increased odds of airflow limitation, with an adjusted odds ratio of 2.23.

The observational findings do not establish why lung function differed between the groups. However, the consistency across spirometry measurements, airflow patterns, and patient reported symptoms supports greater clinical awareness of pulmonary comorbidities in liver transplant recipients.

Recognition of dyspnea and impaired lung function may help clinicians identify recipients who warrant further pulmonary evaluation.

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Labels: chronic pulmonary abnormalities, dyspnea, liver transplant, poor lung function, recipients, show under-recognised comorbidity, spirometry measurements

It is hard to imagine a balanced meal without foods containing vitamin B12. This water-soluble vitamin, explains a registered nurse and director of ambulatory nutrition services at Mount Sinai Hospital, is essential for nervous system function, blood cell formation, metabolism, DNA production, and many other vital processes in the body.

Foods containing vitamin B12 are easy to incorporate into your daily diet. Whether you follow a plant-based diet or eat animal products, B12 can be found across a range of food groups. In addition, these foods often contain other important nutrients, such as omega-3 fatty acids, protein, and iron. If you want to check whether you are getting enough B12 or would like to increase your intake, these are the best sources:

1. Mussels

If you enjoy shellfish, mussels are an excellent source of vitamin B12. According to the US National Institutes of Health (NIH), 85 g of mussels contains around 17 mcg of B12. They also contain iron, making them excellent for energy and red blood cell production.

2. Liver (beef, chicken, and others)

Liver is a true nutritional powerhouse, rich in B12, iron, and vitamin A. A serving of beef or chicken liver contains as much as 70.7 mcg of B12, which is nearly 3,000% of the recommended daily value.

3. Salmon

Salmon is a well-known source of B12, containing around 2.6 mcg per serving, as well as omega-3 fatty acids that support brain and heart health.

4. Trout

Another fish rich in B12 and omega-3 fatty acids. A trout fillet contains around 4.6 mcg of vitamin B12.

5. Tuna

Tuna is well known as a source of protein, but it also contains B12. Three ounces, or around 85 g, of tuna contains approximately 2.5 mcg of vitamin B12.

6. Eggs

Eggs are a simple and versatile food rich in protein and B12. One large egg contains around 0.5 mcg of B12.

7. Cow’s milk

Whole pasteurized milk is an excellent source of calcium, protein, vitamin D, and B12. One cup of 2% milk contains around 1.3 mcg of B12.

8. Yogurt

Plain nonfat yogurt, around 170 g, contains approximately 1 mcg of vitamin B12.

9. Sardines

Canned sardines are an excellent source of B12, containing 8.22 mcg per can, as well as calcium and omega-3 fatty acids.

10. Lean beef

Lean beef is rich in protein, iron, and vitamin B12. An 85 g serving contains around 2.4 mcg.

11. Nutritional yeast

A popular vegan ingredient with a cheesy flavor, nutritional yeast is often fortified with vitamin B12. A quarter cup may contain between 8.3 and 24 mcg of this vitamin.

What does vitamin B12 do in the body?

Vitamin B12 helps convert food into energy, supports the nervous system, red blood cell and DNA production, and may reduce the risk of heart disease. It also plays a role in regulating emotions and producing serotonin.

How much vitamin B12 do we need each day?

The recommended daily intake is between 2.4 and 2.8 mcg. Pregnant women need around 2.6 mcg, while breastfeeding women may increase their intake to 2.8 mcg.

Should I take vitamin B12 supplements?

Ideally, B12 should be obtained through a balanced diet. However, if you have absorption problems, such as pernicious anemia, or do not get enough from food, supplements in the form of tablets or injections may be helpful, with a doctor’s guidance, of course.

Are there any side effects?

B12 is generally safe because any excess is excreted in urine. In rare cases, high doses may cause headaches or nausea. It may also affect the action of certain medications, such as stomach acid inhibitors and metformin, so consulting a doctor before taking supplements is recommended.