Perioperative Skeletal Muscle Fluctuations in High-Acuity Liver Transplantation

Chong, Jazlyn; Guorgui, Jacob; Coy, Heidi; Itô, Takahiro; Lu, Michelle; DiNorcia, Joseph; Agopian, Vatche G.; Farmer, Douglas G.; Raman, Steven S.; Busuttil, Ronald W.; Kaldas, Fady M.

doi:10.1016/j.jss.2021.09.030

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…9,11,12,19,41,52 57,60,70,78,84,87,94,96,97,113,120,133,138,139 Two studies included patients who underwent emergent liver transplant following acute liver failure. 87,139 SMI was the most common parameter. Sarcopenia was associated with increased mortality, graft failure, reduced OS, and increased postoperative complications and infections in these studies, except for the study by Dhaliwal et al, 96 in which there was no difference in clinical outcomes between sarcopenic and nonsarcopenic patients.…”

Section: Sarcopenia and Liver Transplantmentioning

confidence: 99%

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Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review

Farook

Soni

Shantagiri

et al. 2023

Journal of Gastrointestinal and Abdominal Radiology

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Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. The diagnosis of sarcopenia is based on documentation of two of the three criteria: low muscle mass, low muscle strength, and low physical performance. Imaging-based assessment of muscle mass is preferred in both clinical and research settings. Anthropometry for the evaluation of muscle mass is prone to errors and is not recommended in the clinical setting.There is a lack of literature on the radiological assessment of sarcopenia and its association with prognosis in hepatobiliary, pancreatic, and gastrointestinal diseases. Thus, we aim to provide a review of studies that utilized radiological methods to assess sarcopenia and evaluate its impact on outcomes in patients with these diseases.

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Section: Sarcopenia and Liver Transplantmentioning

confidence: 99%

“…In this subgroup, there were 20 retrospective studies (4,168 patients) that assessed outcomes of sarcopenia in patients who underwent liver transplantation or had been waitlisted for the transplant procedure ( Table 5 ). 9 11 12 19 41 52 57 60 70 78 84 87 94 96 97 113 120 133 138 139…”

Section: Introductionmentioning

confidence: 99%

Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review

Farook

Soni

Shantagiri

et al. 2023

Journal of Gastrointestinal and Abdominal Radiology

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“…They discovered an incidence of 15% new sarcopenia post-operatively, and these individuals were 10 times as likely to die, in comparison to those that remained non-sarcopenic [ 57 ]. A recent study has also shown that a greater deterioration in skeletal muscle index is associated with higher rates of graft failure and mortality in liver transplant recipients [ 58 ].…”

Section: Diagnosing Sarcopeniamentioning

confidence: 99%

Acute Sarcopenia after Elective and Emergency Surgery

Shrestha¹,

Dani²,

Kemp³

et al. 2022

Aging and disease

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Sarcopenia is an increasingly recognised condition of loss of muscle mass and function. The European Working Group on Sarcopenia in Older People 2 (EWSOP2) updated their definition in 2018, emphasising the importance of low muscle strength in diagnosis. Acute sarcopenia has been arbitrarily defined as sarcopenia lasting less than 6 months. This review highlights the pathophysiology involved in muscle wasting following surgery, focussing on hormonal factors, inflammation, microRNAs, and oxidative stress. Biomarkers such as GDF-15, IGF-1 and various microRNAs may predict post-surgical muscle loss. The impact of existing sarcopenia on various types of surgery and incident muscle wasting following surgery is also described. The gaps in research found include the need for longitudinal studies looking in changes in muscle strength and quantity following surgery. Further work is needed to examine if biomarkers are replicated in other surgery to consolidate existing theories on the pathophysiology of muscle wasting

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“…[9][10][11] These physiologic alterations are especially pronounced in patients with high medical acuity. 9,12,13 The state of "physical frailty" associated with ESLD is an inseparable, independent predictor of mortality both prior to 8,9,14 and following liver transplantation. [15][16][17][18][19] Evaluation of frailty parameters is critical in liver transplant candidate assessment, 19 but traditional physical and nutritional assessments are di cult, time consuming, and may exhibit signi cant observer bias, putting their clinical utility and reproducibility into question.…”

Section: Introductionmentioning

confidence: 99%

Identification and Internal Validation of a Novel Pre-Transplant Biomarker Panel to Predict Mortality Following Liver Transplantation: The Liver Immune Frailty Index

Panayotova

Simonishvili

Nguyen

et al. 2023

Preprint

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Cirrhosis-related immune dysfunction is well recognized and may contribute to early mortality following liver transplant (LT). The purpose of the present study was to identify pre-transplant biomarkers of immune dysfunction (i.e., immune frailty) that might accurately predict risk of early mortality following LT. Patient plasma was collected immediately prior to LT (T0) and analyzed via Luminex (N=279). On multivariate analysis, HCV IgG, Fractalkine, and MMP3 were significant predictors of 1yr post-LT mortality and were utilized to comprise a novel Liver Immune Frailty Index (LIFI). The LIFI stratifies LT recipients into -low, -moderate, and –high risk tertiles. One-year mortality was 1.4% for LIFI-low, 12.7% for LIFI-moderate, and 58.3% for LIFI-high. Internal validation through bootstrap resampling with 2000 replicates demonstrated the final LIFI model predicts early post-LT mortality with C-statistic=0.84. This novel index may identify patients at risk for persistent severe immune dysfunction and early mortality following LT.

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Perioperative Skeletal Muscle Fluctuations in High-Acuity Liver Transplantation

Cited by 8 publications

References 34 publications

Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review

Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review

Acute Sarcopenia after Elective and Emergency Surgery

Identification and Internal Validation of a Novel Pre-Transplant Biomarker Panel to Predict Mortality Following Liver Transplantation: The Liver Immune Frailty Index

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