Impact of sarcopenic obesity on outcomes in patients undergoing living donor liver transplantation

Işıklar, Aysun; Safer, Umut; Safer, Vildan Binay; Yiyit, Nurettin

doi:10.1016/j.clnu.2019.01.026

Cited by 6 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diagnostic criteria for sarcopenia are still being discussed [48]. Sarcopenia might be well associated with obesity and, therefore, even more difficult to detect [49,50].…”

Section: Pathophysiology Of Malnutrition In Spktx-transplant Recipientsmentioning

confidence: 99%

Nutritional Risk of Candidates for Simultaneous Pancreatic–Kidney Transplantation—A Narrative Review

Mizerska,

Durlik,

Kędzierska-Kapuza

2023

Nutrients

View full text Add to dashboard Cite

Introduction: Not much is known about the significance of nutritional status and support in transplant surgery, least of all in simultaneous pancreatic and kidney transplantation. Malnutrition in the context of simultaneous pancreatic–kidney transplantation seems to be complex and a still poorly investigated problem. Since SPKTX is highly qualified and also has a small volume procedure, it is difficult to obtain data from large cohorts of patients. The aim of this article is to gather existing evidence and information about the subject, as well as to elicit some questions and goals for the future. Methods: We searched through the Pub-Med database using the keywords “pancreas and kidney transplantation” combined with “nutritional risk”, “nutritional status”, “malnutrition”, “nutritional intervention”, and “frailty”, finding a total of 4103 matching results. We then narrowed it down to articles written in English with the full text available. We also researched through the references of articles most accurately matching our researched terms. Results: There are numerous tools that have been investigated for the screening of malnutrition, such as the NRI index, PNI index, NLR, SGA scale, and NRS-2002 scale, each of which proved to be of some use in predicting patient outcomes in different surgical settings. Since all of them differed in components and assessed parameters and, in the absence of more sensitive or infallible indicators, the most reasonable approach seems to evaluate them jointly. Conclusion: It is important to underline the necessity of nutritional screening and the subsequent introduction of adequate therapy while awaiting transplantation in an attempt to improve results. Considering the complexity of surgical procedures and the severity of underlying diseases with their intense metabolic components, the patient’s nutritional status seems to significantly influence results. Consequently, nutritional risk assessments should be a part of the routine care of patients qualified for transplantation.

show abstract

“…Diagnostic criteria for sarcopenia are still being discussed [48]. Sarcopenia might be well associated with obesity and, therefore, even more difficult to detect [49,50].…”

Section: Pathophysiology Of Malnutrition In Spktx-transplant Recipientsmentioning

confidence: 99%

Nutritional Risk of Candidates for Simultaneous Pancreatic–Kidney Transplantation—A Narrative Review

Mizerska,

Durlik,

Kędzierska-Kapuza

2023

Nutrients

View full text Add to dashboard Cite

show abstract

“…Early enteral nutrition (EEN) has been a mainstay of ERAS protocols in abdominal surgery with reduced length of stay, reduced postoperative complications and improved sur-vival in gastrectomies, liver transplants and surgery involving bowel anastomoses [164][165][166][167][168][169]. Although there have not been RCTs evaluating EEN in pancreatic transplantation, it remains in the EPSEN (European Society for Clinical Nutrition and Metabolism) guidelines.…”

Section: Postoperative Nutritionmentioning

confidence: 99%

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

Elango

Papalois

2021

JCM

View full text Add to dashboard Cite

Enhanced recovery after surgery (ERAS) initially started in the early 2000s as a series of protocols to improve the perioperative care of surgical patients. They aimed to increase patient satisfaction while reducing postoperative complications and postoperative length of stay. Despite these protocols being widely adopted in many fields of surgery, they are yet to be adopted in pancreatic transplantation: a high-risk surgery with often prolonged length of postoperative stay and high rate of complications. We have analysed the literature in pancreatic and transplantation surgery to identify the necessary preoperative, intra-operative and postoperative components of an ERAS pathway in pancreas transplantation.

show abstract

“…This represents an advanced stage of abnormal distribution of body composition, which is also thought to worsen the outcome after liver resection and liver transplantation. [16][17][18][19] In a meta-analysis by Hegyi et al, [19] who discussed the association between SO and survival after liver transplantation, pretransplant SO was shown to be a risk factor and was associated with a 2-fold increase in mortality at short-term and long-term follow-up. Furthermore, patients with sarcopenic obesity are thought to show worse survival after LDLT than nonsarcopenic/nonobese patients.…”

Section: Introductionmentioning

confidence: 99%

“…The presence of sarcopenia in an obese state describes the situation of “sarcopenic obesity” (SO). This represents an advanced stage of abnormal distribution of body composition, which is also thought to worsen the outcome after liver resection and liver transplantation 16–19 . In a meta-analysis by Hegyi et al, 19 who discussed the association between SO and survival after liver transplantation, pretransplant SO was shown to be a risk factor and was associated with a 2-fold increase in mortality at short-term and long-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenic obesity may predict worse liver regeneration after right graft living donor liver transplantation

Ali Deeb,

Settmacher,

Fritsch

et al. 2023

Liver Transplantation

View full text Add to dashboard Cite

Sarcopenic obesity impairs the outcome after liver transplantation. The effect of this on liver regeneration has not yet been studied. The aim of this study was to evaluate the potential effect of body composition changes on liver volume gain after living donor liver transplantation. We observed liver regeneration in 100 patients who underwent living donor liver transplantation using right lobe grafts (Segments V-VIII). Liver volumetry and body composition analysis were performed based on computed tomography images with special software. The gain of liver volume was calculated between two points in time considering the absolute and percentage values: before surgery and early after surgery with a median time of 10 days. Pearson’s correlation and multivariate analysis using stepwise multiple regression were used to examine the potential correlation between body composition and liver volume gain. Liver volume increase was significantly negatively correlated with adipose tissue in the body stem (r = −0.4, p < 0.001) and positively correlated with psoas mass (r = 0.24, p = 0.02). These results correspond with those of the multiple regression analysis, which indicated adipose tissue (ß = −1.0, p < 0.001) and psoas mass (ß = 0.12, p < 0.001). The presence of malignancy as an indication for liver transplantation was another significant independent factor negatively affecting liver growth (ß = −13.1, p = 0.046). Sarcopenic obesity predicts an impaired liver volume increase after living donation. This could worsen the postoperative outcome. The role of alimentary interventions and exercises in improving body composition and thus postoperative outcome should be evaluated through prospective interventional studies.

show abstract

Impact of sarcopenic obesity on outcomes in patients undergoing living donor liver transplantation

Cited by 6 publications

References 3 publications

Nutritional Risk of Candidates for Simultaneous Pancreatic–Kidney Transplantation—A Narrative Review

Nutritional Risk of Candidates for Simultaneous Pancreatic–Kidney Transplantation—A Narrative Review

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

Sarcopenic obesity may predict worse liver regeneration after right graft living donor liver transplantation

Contact Info

Product

Resources

About