Nutritional management strategies post-liver transplantation: a comparative review of pediatric and adult recipients

Postoperative malnutrition occurs in 30-60% of liver transplant recipients and impairs perioperative recovery and long-term survival. Distinct malnutrition phenotypes exist across age groups, adult recipients mainly develop sarcopenia driven by sustained hypercatabolism, while pediatric counterparts suffer growth retardation and feeding dysfunction resulting from congenital cholestasis and high anabolic demands. Current studies mostly focus on short-term nutritional support, lacking age-stratified full-cycle intervention covering pre-transplant, early postoperative and long-term maintenance phases, and insufficiently summarize differentiated micronutrient supplementation schemes. This review systematically comparing pathological, metabolic, psychological and nutritional discrepancies between pediatric and adult liver transplant recipients. This review delineates age-specific requirements for macronutrients, fat- and water-soluble vitamins, and trace elements, and summarizes stratified nutritional assessment modalities, enteral and parenteral feeding regimens, and targeted interventions to counteract metabolic adverse effects induced by immunosuppressive agents. Multidisciplinary, staged individualized nutritional regimens are proposed to correct malnutrition, promote catch-up growth in children, preserve muscle mass and reduce metabolic complications in adults, providing evidence-based guidance for clinical precision nutritional management after liver transplantation.