Gait Speed and Grip Strength Are Associated With Dropping Out of the Liver Transplant Waiting List

Kulkarni, Shreyus S.; Chen, H.; Josbeno, Deborah A.; Schmotzer, A.; Hughes, Christopher; Humar, Abhinav; Sood, Puneet; Rachakonda, Vikrant; Dunn, Michael A.; Tevar, Amit D.

doi:10.1016/j.transproceed.2019.01.030

Cited by 21 publications

(11 citation statements)

References 16 publications

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“…GS is the most frequently used tool for the assessment of physical performance. GS was found to be associated with the development of cirrhotic complications, waitlist mortality, and post-LT complications in patients with cirrhosis [114][115][116][117]. In the consensus definition for community-dwelling elderly people, the recommended cutoff value for the diagnosis of low physical performance was 0.8 m/s regardless of sex [1,2].…”

Section: Gait Speedmentioning

confidence: 99%

Definition of Sarcopenia in Chronic Liver Disease

Son

Song

Chang

et al. 2021

Life

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Sarcopenia, which is characterized by decline in muscle mass, muscle strength, and physical performance, is common in patients with chronic liver disease (CLD) and is associated with poor clinical outcomes. Several consensus definitions for community-dwelling elderly people have been proposed, and these recommend the use of various tools and tests to assess muscle properties and performance. These measurement tools have also been applied in patients with CLD and have been useful for predicting prognosis. However, sarcopenia and its diagnostic criteria specific to patients with CLD have not yet been clearly defined. In addition, fluid retention and body composition should be considered when sarcopenia is assessed in patients with CLD. This review aims to introduce definitions of sarcopenia and diagnostic tools used in patients with CLD.

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Section: Gait Speedmentioning

confidence: 99%

Definition of Sarcopenia in Chronic Liver Disease

Son

Song

Chang

et al. 2021

Life

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“…Many studies have shown that this parameter is independently related to an elevated risk of morbidity and mortality 26 . Reduced GS, often observed in patients with CLDs, is linked to adverse clinical outcomes, such as malnutrition and progression of liver failure 27–30 . Our recent research reported that reduced GS is associated with the incidence of composite hepatic events (liver failure, severe infection, hepatocellular carcinoma, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…26 Reduced GS, often observed in patients with CLDs, is linked to adverse clinical outcomes, such as malnutrition and progression of liver failure. [27][28][29][30] Our recent research reported that reduced GS is associated with the incidence of composite hepatic events (liver failure, severe infection, hepatocellular carcinoma, etc.) in patients with CLDs.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of the finger‐circle test in patients with liver diseases

Nishikawa

Enomoto

Nishimura

et al. 2021

Hepatology Research

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Aim To elucidate the relationship between the finger‐circle test (Yubi‐wakka [in Japanese] test; three levels of bigger, just‐fits, and smaller) and sarcopenia‐related factors and anthropometric parameters in patients with chronic liver disease (n = 202, 99 men, mean age 61 years). Methods Patients with both grip strength decline (<26 kg for men and <18 kg for women) and skeletal muscle index (SMI) decline (<7.0 kg/m2 in men and <5.7 kg/m2 in female) were diagnosed as sarcopenia. Results Liver cirrhosis was found in 56 patients (27.7%). The proportions of bigger, just‐fits, and smaller in liver cirrhosis versus non‐liver cirrhosis patients were 51.8%, 21.4%, and 26.8% versus 77.4%, 11.4%, and 8.2% (p < 0.01). The proportions of grip strength decline in patients with bigger, just‐fits, and smaller were 12.0% (77/142), 21.2% (7/33), and 40.7% (11/27; overall p < 0.01). The proportions of SMI decline in patients with bigger, just‐fits, and smaller were 9.9% (14/142), 45.5% (15/33), and 77.8% (21/27; overall p < 0.01). The proportions of sarcopenia in patients with bigger, just‐fits, and smaller were 3.5% (5/142), 18.2% (6/33), and 33.3% (9/27; overall p < 0.01). In both sexes, arm circumference, triceps skinfold thickness, calf circumference, and waist circumference were significantly stratified according to the finger‐circle test. In the multivariate analysis, smaller was an independent predictor for SMI decline (p < 0.01, risk ratio 8.188, bigger as a reference), and body mass index was an independent predictor for both SMI decline and sarcopenia. Conclusion The finger‐circle test can be helpful for the screening of sarcopenia in chronic liver disease and is closely linked to body composition.

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“…Presumably, the pre‐listing patient selection process identifies patients at higher risk for death who are not suitable for transplant. Studies of frailty in the larger population undergoing transplant evaluation continue to advance our understanding of this vulnerable group, and expansion of the literature to SLKT candidates is important to improve patient care 26‐28 …”

Section: Discussionmentioning

confidence: 99%

Karnofsky performance status predicts outcomes in candidates for simultaneous liver‐kidney transplant

Shamseddeen

Pike

Ghabril

et al. 2020

Clinical Transplantation

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Karnofsky performance status (KPS), a measure of physical frailty, predicts pre‐transplant and post‐transplant outcomes in liver transplantation, but has not been assessed in simultaneous liver–kidney transplantation (SLKT). We examined the association between KPS and outcomes in SLKT waitlist registrants and recipients (2005‐2018) in the UNOS database. KPS was categorized into A (able to work), B (able to provide self‐care), and C (unable to provide self‐care). Cox regression and competing risk analysis were used to assess the association between KPS groups and outcomes. A total of 10,785 patients were waitlisted (KPS: 19% A, 46% B, 35% C), and 5,516 underwent SLKT (12% A, 36% B, 52% C). One‐year waitlist mortality was 17%, 22%, and 32% for KPS A, B, and C, respectively. In adjusted competing risk regression, KPS C was associated with increased waitlist mortality (SHR 1.15, 95%CI 1.04‐1.28). One‐year post‐transplant survival was 92%, 91%, and 87% for KPS A, B, and C, respectively. In adjusted Cox regression, KPS C was associated with increased post‐transplant mortality (HR 1.32, 95%CI 1.08‐1.61). It was also associated with increased liver and kidney graft losses and with hospital length of stay. Frailty, as assessed by KPS, is associated with poor outcomes in SLKT pre‐ and post‐transplant.

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Gait Speed and Grip Strength Are Associated With Dropping Out of the Liver Transplant Waiting List

Cited by 21 publications

References 16 publications

Definition of Sarcopenia in Chronic Liver Disease

Definition of Sarcopenia in Chronic Liver Disease

Clinical impact of the finger‐circle test in patients with liver diseases

Karnofsky performance status predicts outcomes in candidates for simultaneous liver‐kidney transplant

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