Both sarcopenia and frailty determine suitability of patients for liver transplantation-A systematic review and meta-analysis of the literature.
Kahn J, Wagner D, et al.Clinical Transplantation 2018; 32(4) :e13226.
Aims
To conduct a systematic review and meta-analysis to evaluate both frailty and sarcopenia in liver transplantation (LT).
Interventions
The databases PubMed and Google Scholar were searched to identify primary research articles, review articles, and practice guidelines published between 1998 and 2017 on frailty and sarcopenia among patients undergoing LT. One investigator performed an initial screen of identified titles and abstracts, and two independent investigators performed a second screen. The references of relevant articles were also reviewed to identify potentially eligible studies. The methodological quality of the included studies was independently assessed by two investigators using the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies.
Participants
13 studies were included in the systematic review, of which 6 were used for the meta-analysis.
Outcomes
The primary outcomes measured were sarcopenia and frailty. Waitlist mortality was the outcome utilised in the meta-analysis, and other outcomes measured included muscle functionality, 1-year survival, 30-90 day mortality, complication risk, hospitalisations and quality of life.
Follow-up
Not described
CET Conclusions
This systematic review was perhaps limited in its range by searching only google scholar and pubmed, and only studies published in English were included. The abstracts were screened by only one reviewer initially, although a second screening was done with two reviewers. The included studies were assessed for quality using the Newcastle-Ottawa scale, which is appropriate for this type of study. The review does compile evidence on sarcopenia and frailty measurements in liver transplant recipients but could have had a more focussed primary outcome. It will come as no surprise that reduced functionality correlates with adverse outcome post-transplant.
Quality notes
Quality assessment not appropriate
Trial registration
None