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Relationship between sarcopenia,six‐minute walk distance and health‐related quality of life in liver transplant candidates
Authors:Anitha Yadav  Yu‐Hui Chang  Sarah Carpenter  Alvin C Silva  Jorge Rakela  Bashar A Aqel  Thomas J Byrne  David D Douglas  Hugo E Vargas  Elizabeth J Carey
Institution:1. Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA;2. Division of Health Sciences Research, Mayo Clinic, Phoenix, AZ, USA;3. Division of Radiology, Mayo Clinic, Phoenix, AZ, USA
Abstract:Sarcopenia, or loss of skeletal muscle mass, is associated with increased mortality and morbidity in liver transplant (LT) candidates. Six‐minute walk distance (6MWD) and health‐related quality of life (HRQOL) as assessed by short form 36 scores (SF‐36) also impact clinical outcomes in these patients. This study explored the relationship between the sarcopenia, 6MWD, and HRQOL in LT candidates. Sarcopenia was evaluated based on skeletal muscle mass index (SMI) quantified from abdominal computed tomography. Patients were followed until death, removal from the wait list or the end of the study period. Two hundred and thirteen patients listed for LT were included. The mean SMI, 6MWD and mean gait speed were 54.3 ± 9.7, 370.5 m and 1 m/s, respectively. Sarcopenia was noted in 22.2% of LT candidates. There was no correlation between sarcopenia, 6MWD, and SF‐36 scores. The 6MWD, but not sarcopenia, was an independent predictor of mortality (hazard ratio = 2.1 0.9–4.7]). In summary, sarcopenia did not emerge as a significant predictor of waitlist mortality and also failed to correlate with either functional capacity or HRQOL in LT candidates. In patients with ESLD awaiting LT, 6MWD appears to be a more useful prognostic indicator than the presence of sarcopenia.
Keywords:functional capacity  gait speed  muscle mass  prognostic factor  short form‐36 scores
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