Low muscle density and five times sit-to-stand test predict poor outcome in liver transplant candidates

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-12-10 DOI:10.1016/j.clinre.2025.102743

Maxence Lepour , Alicia Delorme , Alexis Goffaux , Pierre Trefois , Elodie Dubois , Caroline Catoul , Frédéric Braem , David de Azevedo , Alix Collard , Nicolas Lanthier , Geraldine Dahlqvist

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引用次数: 0

Abstract

Background

Muscle-related parameters (myopenia, sarcopenia, myosteatosis, frailty) are linked to increased mortality in liver transplant candidates but have not been prospectively compared in the same cohort.

Aim

This study aimed to identify the most accurate muscle predictor of morbidity and mortality in patients with cirrhosis on the liver transplant waiting list.

Methods

A prospective, single-center study included all consenting adult liver transplant candidates from June 2021 to October 2023. Skeletal muscle mass index, muscle density, and myosteatosis were assessed via computed tomography at third lumbar vertebrae. Frailty was evaluated using the liver frailty index and the 6-minute walk test.

Results

Among 194 screened patients, 135 were listed for transplant, including 108 with cirrhosis. Alcohol-related liver disease was the leading etiology, 47 % were listed for hepatocellular carcinoma. Myopenia was present in 31 %, myosteatosis in 34 %, and 20 % were frail. One-year survival was 82 %. Myosteatosis was the strongest univariate predictor of mortality, but in multivariate analysis, the five times sit to stand test was the best predictor of morbi-mortality.

Conclusion

The five times sit to stand test emerged as the most robust predictor in multivariate analysis. Its simplicity and reliability make it a valuable tool for identifying high-risk patients on the liver transplant waiting list.

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低肌肉密度和5次坐立试验预测肝移植候选人预后不良。

背景：在肝移植候选者中，肌肉相关参数（肌减少症、肌肉减少症、肌骨增生症、虚弱）与死亡率增加有关，但尚未在同一队列中进行前瞻性比较。目的：本研究旨在确定肝移植等待名单上肝硬化患者发病率和死亡率最准确的肌肉预测因子。方法：一项前瞻性单中心研究纳入了2021年6月至2023年10月期间所有同意的成人肝移植候选人。通过第三腰椎计算机断层扫描评估骨骼肌质量指数、肌肉密度和骨骼肌骨化症。使用肝衰弱指数和6分钟步行试验来评估衰弱程度。结果：194例患者中，135例被列入移植名单，其中肝硬化患者108例。酒精相关性肝病是主要病因，47%被列为肝细胞癌。31%的患者有肌肉萎缩，34%的患者有肌骨化症，20%的患者身体虚弱。一年生存率为82%。肌骨化病是死亡率最强的单因素预测因子，但在多因素分析中，5次坐位测试是发病率-死亡率的最佳预测因子。结论：在多变量分析中，5次坐站立检验是最可靠的预测因子。它的简单性和可靠性使其成为识别肝移植等待名单上高危患者的宝贵工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.