Prognostic implications of physical frailty and sarcopenia pre and post transplantation
The development of frailty and sarcopenia has many shared risk factors with the occurrence of cirrhosis. In turn, cirrhosis influences the course of frailty and sarcopenia. Frailty and sarcopenia metrics can be used to enhance current recipient selection and prioritization tools such as the MELD score, in order to reduce waitlist mortality and improve long-time prognosis for transplanted patients. Both syndromes may be influenced by interventions prior to and after transplantation. Strategies should be multidimensional and, at least, be a combination of nutrition, exercise, and ammonia-lowering therapies with or without novel pharmacological therapy. In order to enhance selection of patients and enact interventions, a standardized and practical definition of frailty and sarcopenia is required. Only in this way can the prognostic implications of these syndromes be employed to their full potential to improve care in transplantation patients.
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Büttner, S, IJzermans, J.N.M, & van Vugt, J.L.A. (2019). Prognostic implications of physical frailty and sarcopenia pre and post transplantation. In Frailty and Sarcopenia in Cirrhosis: The Basics, the Challenges, and the Future (pp. 55–76). doi:10.1007/978-3-030-26226-6_5