PURPOSE OF REVIEW: Sarcopenia is highly prevalent in end-stage liver disease (ESLD) patients and has been linked to poor outcomes on the wait list and post-transplantation. This current perspectives article reviews the ongoing challenges to define sarcopenia in ESLD patients, describes associations of sarcopenia with wait-list and post-transplantation outcomes, and provides summarized data on efforts to prevent and treat sarcopenia through novel interventions. RECENT FINDINGS: Supervised exercise programs improve muscle strength, but muscle mass outcomes are limited by short study follow-up times. Branched chain amino acid supplementation may ameliorate sarcopenia in ESLD patients, but studies limited by low participant numbers and confounding. Myostatin inhibition shown to improve sarcopenia in elderly, frail patients; further study needed in ESLD patients. Correction of low testosterone improves sarcopenia in male ESLD patients. SUMMARY: Recent literature supports sarcopenia as an independent risk factor for poor outcomes in ESLD patients. Ongoing study is limited by poor standardization of sarcopenia definition and relevant muscle-mass cutoffs. Supervised exercise programs should be encouraged for all ESLD patients. More advanced therapies require further clinical investigation before their widespread use.
PURPOSE OF REVIEW: Sarcopenia is highly prevalent in end-stage liver disease (ESLD) patients and has been linked to poor outcomes on the wait list and post-transplantation. This current perspectives article reviews the ongoing challenges to define sarcopenia in ESLD patients, describes associations of sarcopenia with wait-list and post-transplantation outcomes, and provides summarized data on efforts to prevent and treat sarcopenia through novel interventions. RECENT FINDINGS: Supervised exercise programs improve muscle strength, but muscle mass outcomes are limited by short study follow-up times. Branched chain amino acid supplementation may ameliorate sarcopenia in ESLD patients, but studies limited by low participant numbers and confounding. Myostatin inhibition shown to improve sarcopenia in elderly, frail patients; further study needed in ESLD patients. Correction of low testosterone improves sarcopenia in male ESLD patients. SUMMARY: Recent literature supports sarcopenia as an independent risk factor for poor outcomes in ESLD patients. Ongoing study is limited by poor standardization of sarcopenia definition and relevant muscle-mass cutoffs. Supervised exercise programs should be encouraged for all ESLD patients. More advanced therapies require further clinical investigation before their widespread use.
Authors: Rahima A Bhanji; Carlos Moctezuma-Velazquez; Andres Duarte-Rojo; Maryam Ebadi; Sunita Ghosh; Christopher Rose; Aldo J Montano-Loza Journal: Hepatol Int Date: 2018-06-07 Impact factor: 6.047
Authors: Patrick W Underwood; David C Cron; Michael N Terjimanian; Stewart C Wang; Michael J Englesbe; Seth A Waits Journal: Clin Transplant Date: 2015-10-15 Impact factor: 2.863
Authors: Carlos Moctezuma-Velázquez; Gavin Low; Marina Mourtzakis; Mang Ma; Kelly W Burak; Puneeta Tandon; Aldo J Montano-Loza Journal: Ann Hepatol Date: 2018 July - August , Impact factor: 2.400
Authors: Benedict Kinny-Köster; Michael Bartels; Susen Becker; Markus Scholz; Joachim Thiery; Uta Ceglarek; Thorsten Kaiser Journal: PLoS One Date: 2016-07-13 Impact factor: 3.240
Authors: Alejandro Pita; Ioannis A Ziogas; Fei Ye; Yufan Chen; Muhammad A Rauf; Lea K Matsuoka; Navpreet Kaur; Gilbert Whang; Shannon M Zielsdorf; Gerasimos Bastas; Manhal Izzy; Sophoclis P Alexopoulos Journal: Transplant Direct Date: 2020-10-20
Authors: Xiaomeng Chen; Omid Shafaat; Yi Liu; Elizabeth A King; Clifford R Weiss; Qian-Li Xue; Jeremy D Walston; Dorry L Segev; Mara A McAdams-DeMarco Journal: Am J Transplant Date: 2022-01-08 Impact factor: 9.369
Authors: Johanna Abrigo; Fabián Campos; Francisco Gonzalez; Francisco Aguirre; Andrea Gonzalez; Camila Huerta-Salgado; Sabrina Conejeros; Felipe Simon; Marco Arrese; Daniel Cabrera; Alvaro A Elorza; Claudio Cabello-Verrugio Journal: Int J Mol Sci Date: 2020-10-25 Impact factor: 5.923