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Current Gastroenterology Reports

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01-11-2018 | Liver (S Cotler and E Kallwitz, Section Editors)

Should Sarcopenia Increase Priority for Transplant or Is It a Contraindication?

Authors: Guido Stirnimann, Maryam Ebadi, Puneeta Tandon, Aldo J. Montano-Loza

Published in: Current Gastroenterology Reports | Issue 11/2018

Abstract

Purpose of Review

The purpose of this review is to discuss the current evidence regarding the impact of sarcopenia on patients with cirrhosis awaiting liver transplantation and to determine if its presence should be considered a criterion for expedited transplantation or a contraindication for transplantation.

Recent Findings

Sarcopenia is a negative predictor of survival in patients on a waiting list and after liver transplant. The gut-liver axis and the liver-muscle axis have been explored to understand the complex pathophysiology of sarcopenia.

Summary

Sarcopenia is a frequent finding in patients with cirrhosis. The diagnosis is ideally based on cross-sectional image analysis (CT or MRI) and treatment consists of optimization of caloric and protein intake. To date, prioritizing tools for liver transplantation have not included nutrition or sarcopenia parameters. Patients with a low Model for End-Stage Liver Disease (MELD) or MELD-Na score and sarcopenia would benefit from prioritization for transplant in order to reduce time on waiting list and therefore mortality.

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Title: Should Sarcopenia Increase Priority for Transplant or Is It a Contraindication?
Authors: Guido Stirnimann
Maryam Ebadi
Puneeta Tandon
Aldo J. Montano-Loza
Publication date: 01-11-2018
Publisher: Springer US
Published in: Current Gastroenterology Reports / Issue 11/2018
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-018-0656-3

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