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Sarcopenia in Liver Transplantation
John Montgomery1, Michael Englesbe1
1Department of Surgery, University of Michigan Health System, Ann Arbor, MI.
Current Transplantation Reports
|October 10, 2019
Summary
Sarcopenia, a muscle-wasting condition, is common in end-stage liver disease (ESLD) and linked to worse outcomes. Exercise shows promise, but more research is needed for other interventions in ESLD patients.
Area of Science:
- Hepatology
- Geriatrics
- Muscle Physiology
Background:
- Sarcopenia is highly prevalent in end-stage liver disease (ESLD) patients.
- It is associated with adverse outcomes during liver transplant waitlisting and post-transplantation.
Purpose of the Study:
- Review challenges in defining sarcopenia in ESLD.
- Describe sarcopenia's associations with patient outcomes.
- Summarize interventions for preventing and treating sarcopenia in ESLD.
Main Methods:
- Literature review of current perspectives on sarcopenia in ESLD.
- Analysis of associations between sarcopenia and clinical outcomes.
- Summary of data on novel therapeutic interventions.
Main Results:
- Supervised exercise improves muscle strength, but effects on muscle mass require longer follow-up.
- Branched-chain amino acid supplementation may help, but studies are limited.
- Myostatin inhibition and testosterone correction show potential but need further investigation in ESLD.
Conclusions:
- Sarcopenia is an independent risk factor for poor outcomes in ESLD.
- Standardization of sarcopenia definition and muscle mass cutoffs is needed.
- Supervised exercise is recommended; advanced therapies require more clinical study.
