Sarcopenia (loss of muscle mass) is commonly seen in patients with end stage liver disease (ESLD). Reduction in health related quality of life and decline in functional capacity is also noted in ESLD patients awaiting liver transplantation (LT). Six minute walk distance (6MWD) and short form 36 (SF-36) can be used to assess functional exercise capacity and quality of life. Both sarcopenia and 6MWD have been shown to predict mortality in LT candidates. However, there are no studies comparing 6MWD, SF- 36 scores, sarcopenia and other clinical parameters between surviving patients and candidates who died while awaiting LT.
To compare the 6MWD, muscle mass, SF-36 scores and other parameters between patients transplanted or still awaiting LT vs. patients who died on the waiting list.
276 patients listed for LT were divided into 2 groups. Group 1(n=217) included all patients who remained on the wait list or underwent LT. Group 2 (n=59) patients who died on the wait list. Data collected: age, gender, etiology of liver disease, albumin, bilirubin, INR, Model for End-Stage Liver Disease (MELD) score, 6MWD, SF-36 scores (physical component score (PSC) and mental component score (MCS). Sarcopenia was assessed by the total psoas area (TPA) on pre-LT cross-sectional imaging (either computerized tomography or magnetic resonance imaging)
Demographics, clinical characteristics and results are shown in Table 1.
|Variable||Group 1||Group 2||p value|
HCV (45%) is the most common etiology of liver disease. Mean TPA area was 1206 mm2 and mean density was 27. hounsfield units.
Group 2 patients had higher MELD score, lower 6MWD and PCs compared to group 1
Measures of physical function are reduced in patients awaiting LT and are associated with increased risk of death on the wait list. Routine measurement of physical function may help to identify patients at increased risk, and allow for targeted interventions. Larger studies are needed to elucidate the prognostic value of 6MWD combined with SF-36 and sarcopenia in ESLD patients.
To cite this abstract in AMA style:Yadav A, Carpenter, Chang, Silva, Aqel, Byrne, Douglas, Vargas, Carey. 6 Minute Walk Distance and Physical Component Score, but Not Sarcopenia, Are Associated with Pre-Transplant Mortality in Patients with End Stage Liver Disease [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/6-minute-walk-distance-and-physical-component-score-but-not-sarcopenia-are-associated-with-pre-transplant-mortality-in-patients-with-end-stage-liver-disease/. Accessed May 26, 2017.
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