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Both sarcopenia and frailty determine suitability of patients for liver transplantation—A systematic review and meta‐analysis of the literature
Author(s) -
Kahn Judith,
Wagner Doris,
Homfeld Nicole,
Müller Helmut,
Kniepeiss Daniela,
Schemmer Peter
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13226
Subject(s) - sarcopenia , medicine , liver transplantation , economic shortage , meta analysis , comparability , systematic review , transplantation , intensive care medicine , gerontology , medline , surgery , linguistics , philosophy , mathematics , combinatorics , government (linguistics) , political science , law
Liver grafts are allocated based on both urgency and utility. Due to a tremendous shortage of suitable organs for liver transplantation (LT), a careful selection of suitable recipients is of utmost importance. While the sickest first principle for organ allocation based on MELD score goes along with poor utility, other parameters reflecting the general health condition like frailty and sarcopenia might be essential to detect suitable patients for the waiting list. Thus, this study was designed to evaluate both frailty and sarcopenia in LT. A systematic review of the literature on sarcopenia and frailty measurements in liver transplant recipients was performed. Thirteen of 238 studies were selected for full paper review. Six of the studies investigating the impact of frailty on waitlist mortality were subjected to a meta‐analysis. Despite the different methodologies to assess sarcopenia, reports showed that sarcopenia was highly related to waitlist mortality with a sum of all that highly favored negative outcome in case of sarcopenia. The existing literature clearly underlines that frailty and sarcopenia are important to determine in LT candidates. One unique index for transplant candidates reflecting frailty should be developed and be used as a standard in all transplant centers to facilitate comparability.