Although liver transplantation cannot be considered a first-line treatment, it is a valid therapeutic option in selected patients who are not amenable to resection. Only 0.17% of the transplants in the United States are performed for this indication, with satisfying long-term results. Age was an independent predictor of patient survival. Further studies are needed to better understand the role of liver transplantation in the treatment of BSLT.
Background
Physical activity has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.
Aim
To evaluate predictors of physical activity and grip strength in cirrhotic patients undergoing liver transplant evaluation.
Methods
Single center, prospective analysis.
Results
A hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic hepatitis (27%), hepatitis C (22%), and alcoholic liver disease (21%). Mean MELD score was 13.5. Forty one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire. The median total physical activity score of 33 MET-min/weeks. The mean total grip strength was 62.1 ± 22lb. Total grip strength was found to be an independent predictor of low-moderate physical activity (OR 4.7, 95% CI 1.4–16.2, p=0.038) and smoking was the only significant factor associated with reduced grip strength (OR 3.4, 95% CI 1.4–8, p=0.005).
Conclusions
End-Stage Liver Disease patients undergoing liver transplant evaluation have reduced total physical activity by IPAQ. Total Grip Strength was found to be a significant predictor of low-moderate physical activity in patients with cirrhosis. Smoking is a risk factor for reduced grip strength, an important indicator of muscle wasting in cirrhotics.
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