Frailty and Sarcopenia in Acute-on-Chronic Liver Failure

Lorena Puchades Renau, Julia Herreras López, Maria Àngels Cebrià I Iranzo, Natalia Cezón Serrano, Tommaso Di Maira, Marina Berenguer, Lorena Puchades Renau, Julia Herreras López, Maria Àngels Cebrià I Iranzo, Natalia Cezón Serrano, Tommaso Di Maira, Marina Berenguer

Abstract

In patients with cirrhosis, sarcopenia is a critical reduction in skeletal muscle mass and frailty represents a status of global physical dysfunction caused by under nutrition, muscle wasting, and functional impairment. Both are prevalent conditions in liver transplant candidates and have shown to be independent predictors of adverse outcome. Evidence supports their incorporation into clinical practice both as a prognostic factor guiding clinical decision making and as a tool to identify candidates for physical and nutritional interventions. The wide heterogeneity of instruments used for sarcopenia and frailty measurement, the absence of a single suitable instrument for sarcopenia and frailty assessment in the outpatient versus inpatient acute-on-chronic clinical scenario, and the lack of strong evidence showing a beneficial effect of sarcopenia and frailty improvement on outcomes before and after transplantation are some of the questions that remain unanswered.

© 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.

Figures

FIG. 1
FIG. 1
Contributors to sarcopenia and physical frailty in patients with end‐stage liver disease.

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