title: Relationship between sarcopenia, six-minute walk distance and health-related quality of life in liver transplant candidates.
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.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Anitha
authors.initials: A
authors.lastname: Yadav
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chang
authors.forename: Sarah
authors.initials: S
authors.lastname: Carpenter
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Silva
authors.forename: Jorge
authors.initials: J
authors.lastname: Rakela
authors.forename: Bashar A
authors.initials: BA
authors.lastname: Aqel
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Byrne
authors.forename: David D
authors.initials: DD
authors.lastname: Douglas
authors.forename: Hugo E
authors.initials: HE
authors.lastname: Vargas
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Carey
mesh_terms: D015992:Body Mass Index; D005080:Exercise Test; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D055948:Sarcopenia / Q000503:physiopathology / Q000523:psychology*; D019737:Transplants; D016138:Walking / Q000502:physiology*
keywords: functional capacity; gait speed; muscle mass; prognostic factor; short form-36 scores