Erschienen in:
01.11.2018 | Liver (S Cotler and E Kallwitz, Section Editors)
Should Sarcopenia Increase Priority for Transplant or Is It a Contraindication?
verfasst von:
Guido Stirnimann, Maryam Ebadi, Puneeta Tandon, Aldo J. Montano-Loza
Erschienen in:
Current Gastroenterology Reports
|
Ausgabe 11/2018
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Abstract
Purpose of Review
The purpose of this review is to discuss the current evidence regarding the impact of sarcopenia on patients with cirrhosis awaiting liver transplantation and to determine if its presence should be considered a criterion for expedited transplantation or a contraindication for transplantation.
Recent Findings
Sarcopenia is a negative predictor of survival in patients on a waiting list and after liver transplant. The gut-liver axis and the liver-muscle axis have been explored to understand the complex pathophysiology of sarcopenia.
Summary
Sarcopenia is a frequent finding in patients with cirrhosis. The diagnosis is ideally based on cross-sectional image analysis (CT or MRI) and treatment consists of optimization of caloric and protein intake. To date, prioritizing tools for liver transplantation have not included nutrition or sarcopenia parameters. Patients with a low Model for End-Stage Liver Disease (MELD) or MELD-Na score and sarcopenia would benefit from prioritization for transplant in order to reduce time on waiting list and therefore mortality.