S S Kulkarni1, H Chen2, D A Josbeno3, A Schmotzer4, C Hughes5, A Humar5, P Sood6, V Rachakonda2, M A Dunn2, A D Tevar5. 1. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: kulkarniss@upmc.edu. 2. Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 3. Department of Physical Therapy, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 4. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 5. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 6. Department of Medicine and Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Abstract
INTRODUCTION: Frailty measures can predict perioperative surgical risk in liver transplant patients. The 5-meter walk test (5MWT) and hand grip strength (HGS) are easy and reproducible frailty measures. We hypothesized that they could capture frailty in liver transplant listed patients and would be associated with dropping out of the waiting list. METHODS: We conducted a retrospective analysis of patients undergoing outpatient liver transplant listing at the University of Pittsburgh Medical Center from 2013 to 2016. We compared demographics, baseline laboratory markers, 5MWT, and HGS between patients who were dropped from the waiting list for medical reasons and those who remained or were successfully transplanted. Bivariate statistical analysis was performed using Fisher exact or χ2 tests. RESULTS: We reviewed 197 patients listed for liver transplant. Average age was 57.1 years (range 20-74), and patients were predominantly white (90.4%). Patients' most common etiology of liver disease was hepatitis C (32.5%), 14 (7.1%) had a previous liver transplant, and average Model for End-Stage Liver Disease score upon listing was 16.0. Of the cohort, 38 (19.3%) were ultimately dropped from the waitlist due to non-hepatocellular carcinoma-related reasons. Patients dropped from the waiting list had weaker HGS (46.14 lb vs 59.6 lb; P < .005) and slower 5MWT speed (5MWT: 0.92 m/s vs 1.03 m/s; P < .005). CONCLUSION: The 5MWT and HGS can easily measure frailty in patients being evaluated for liver transplant. These tests are associated with waiting list dropout, indicating that they can be valuable tools in the evaluation of these patients.
INTRODUCTION: Frailty measures can predict perioperative surgical risk in liver transplant patients. The 5-meter walk test (5MWT) and hand grip strength (HGS) are easy and reproducible frailty measures. We hypothesized that they could capture frailty in liver transplant listed patients and would be associated with dropping out of the waiting list. METHODS: We conducted a retrospective analysis of patients undergoing outpatient liver transplant listing at the University of Pittsburgh Medical Center from 2013 to 2016. We compared demographics, baseline laboratory markers, 5MWT, and HGS between patients who were dropped from the waiting list for medical reasons and those who remained or were successfully transplanted. Bivariate statistical analysis was performed using Fisher exact or χ2 tests. RESULTS: We reviewed 197 patients listed for liver transplant. Average age was 57.1 years (range 20-74), and patients were predominantly white (90.4%). Patients' most common etiology of liver disease was hepatitis C (32.5%), 14 (7.1%) had a previous liver transplant, and average Model for End-Stage Liver Disease score upon listing was 16.0. Of the cohort, 38 (19.3%) were ultimately dropped from the waitlist due to non-hepatocellular carcinoma-related reasons. Patients dropped from the waiting list had weaker HGS (46.14 lb vs 59.6 lb; P < .005) and slower 5MWT speed (5MWT: 0.92 m/s vs 1.03 m/s; P < .005). CONCLUSION: The 5MWT and HGS can easily measure frailty in patients being evaluated for liver transplant. These tests are associated with waiting list dropout, indicating that they can be valuable tools in the evaluation of these patients.
Authors: Marina Serper; Sunny Y Tao; Dorothea S Kent; Patrik Garren; Alexander E Burdzy; Jennifer C Lai; Amir Gougol; Pamela M Bloomer; K Rajender Reddy; Michael A Dunn; Andres Duarte-Rojo Journal: Liver Transpl Date: 2021-08-01 Impact factor: 5.799
Authors: James S Kimber; Richard J Woodman; Sumudu K Narayana; Libby John; Jeyamani Ramachandran; David Schembri; John W C Chen; Kate R Muller; Alan J Wigg Journal: JGH Open Date: 2022-01-12
Authors: Giammauro Berardi; Giulio Antonelli; Marco Colasanti; Roberto Meniconi; Nicola Guglielmo; Andrea Laurenzi; Stefano Ferretti; Giovanni Battista Levi Sandri; Alessandra Spagnoli; Giovanni Moschetta; Vincenzo Schininà; Mario Antonini; Massimo Marignani; Giuseppe Maria Ettorre Journal: JAMA Surg Date: 2020-11-18 Impact factor: 14.766