Li XJ, He K. Sarcopenia in cirrhotic patients: Does frailty matter while waiting for a liver transplant? World J Gastrointest Surg 2024; 16(1): 257-259 [PMID: 38328318 DOI: 10.4240/wjgs.v16.i1.257]
Corresponding Author of This Article
Kang He, MD, Doctor, Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai 200127, China. hekang929@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2024; 16(1): 257-259 Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.257
Sarcopenia in cirrhotic patients: Does frailty matter while waiting for a liver transplant?
Xing-Jie Li, Kang He
Xing-Jie Li, Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, United States
Xing-Jie Li, Kang He, Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Author contributions: Li XJ wrote the manuscript; He K designed the study and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kang He, MD, Doctor, Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai 200127, China. hekang929@163.com
Received: November 10, 2023 Peer-review started: November 10, 2023 First decision: December 4, 2023 Revised: December 7, 2023 Accepted: December 12, 2023 Article in press: December 12, 2023 Published online: January 27, 2024
Abstract
Sarcopenia reflects patient frailty and should be routinely assessed due to its high prevalence in cirrhotic patients awaiting liver transplants. Pre-transplant nutritional optimization should be tailored for patients with a definitive diagnosis of sarcopenia, therefore improving functional status at transplant and reducing post-transplant mortality. Hepatologists and transplant surgeons should have raised awareness regarding sarcopenia and the reflected frailty that hinder posttransplant outcomes. The policymakers should also take into account when modifying the organ allocation model that sarcopenia or frailty might become a decisive factor in allocating organs for cirrhotic patients, in order to ensure post-transplant survival and quality of life.
Core Tip: Sarcopenia is an independent risk factor for mortality in cirrhotic patients waiting for a liver transplant. It is important to recognize sarcopenia at pre-transplant evaluation, provide supportive management and optimize patient conditions prior to the transplant. Also, the future organ allocation policymakers should take into account that cirrhotic patients with sarcopenia carry a potentially higher mortality than reflected by the current model for end-stage liver disease-Na model and therefore in a more urgent need of a liver transplant.
