eprintid: 1476377
rev_number: 34
eprint_status: archive
userid: 608
dir: disk0/01/47/63/77
datestamp: 2016-03-11 14:24:45
lastmod: 2021-09-17 22:56:35
status_changed: 2016-03-11 14:24:45
type: article
metadata_visibility: show
creators_name: Kalafateli, M
creators_name: Mantzoukis, K
creators_name: Choi Yau, Y
creators_name: Mohammad, AO
creators_name: Arora, S
creators_name: Rodrigues, S
creators_name: de Vos, M
creators_name: Papadimitriou, K
creators_name: Thorburn, D
creators_name: O'Beirne, J
creators_name: Patch, D
creators_name: Pinzani, M
creators_name: Morgan, MY
creators_name: Agarwal, B
creators_name: Yu, D
creators_name: Burroughs, AK
creators_name: Tsochatzis, EA
title: Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G91
keywords: Cirrhosis; Prognosis; Nutritional assessment; Morbidity; Mortality
note: Copyright © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
abstract: Background: Although malnutrition and sarcopenia are prevalent in cirrhosis, their impact on outcomes following liver transplantation is not well documented. Methods: The associations of nutritional status and sarcopenia with post-transplant infections, requirement for mechanical ventilation, intensive care (ICU) and hospital stay, and 1year mortality were assessed in 232 consecutive transplant recipients. Nutritional status and sarcopenia were assessed using the Royal Free Hospital-Global Assessment (RFH-GA) tool and the L3-psoas muscle index (L3-PMI) on CT, respectively. Results: A wide range of RFH-SGA and L3-PMI were observed within similar Model for End-stage Liver Disease (MELD) sub-categories. Malnutrition and sarcopenia were independent predictors of all outcomes. Post-transplant infections were associated with MELD (OR=1.055, 95%CI=1.002-1.11) and severe malnutrition (OR=6.55, 95%CI=1.99-21.5); ventilation>24h with MELD (OR=1.1, 95%CI=1.036-1.168), severe malnutrition (OR=8.5, 95%CI=1.48-48.87) and suboptimal donor liver (OR=2.326, 95%CI=1.056-5.12); ICU stay>5days, with age (OR=1.054, 95%CI=1.004-1.106), MELD (OR=1.137, 95%CI=1.057-1.223) and severe malnutrition (OR=7.46, 95%CI=1.57-35.43); hospital stay>20days with male sex (OR=2.107, 95%CI=1.004-4.419) and L3-PMI (OR=0.996, 95%CI=0.994-0.999); 1year mortality with L3-PMI (OR=0.996, 95%CI=0.992-0.999). Patients at the lowest L3-PMI receiving suboptimal grafts had longer ICU/hospital stay and higher incidence of infections. Conclusions: Malnutrition and sarcopenia are associated with early post-liver transplant morbidity/mortality. Allocation indices do not include nutritional status and may jeopardize outcomes in nutritionally compromised individuals.
date: 2017-02
date_type: published
official_url: http://dx.doi.org/10.1002/jcsm.12095
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1117445
doi: 10.1002/jcsm.12095
lyricists_name: Agarwal, Banwari
lyricists_name: Morgan, Marsha
lyricists_name: O'Beirne, James
lyricists_name: Pinzani, Massimo
lyricists_name: Thorburn, Douglas
lyricists_name: Tsochatzis, Emmanouil
lyricists_id: BAGAR28
lyricists_id: MYMOR45
lyricists_id: JOBEI65
lyricists_id: MPINZ74
lyricists_id: DTHOR21
lyricists_id: ETSOC40
actors_name: Tsochatzis, Emmanouil
actors_id: ETSOC40
actors_role: owner
full_text_status: public
publication: Journal of Cachexia, Sarcopenia and Muscle
volume: 8
number: 1
pagerange: 113-121
issn: 2190-6009
citation:        Kalafateli, M;    Mantzoukis, K;    Choi Yau, Y;    Mohammad, AO;    Arora, S;    Rodrigues, S;    de Vos, M;                                         ... Tsochatzis, EA; + view all <#>        Kalafateli, M;  Mantzoukis, K;  Choi Yau, Y;  Mohammad, AO;  Arora, S;  Rodrigues, S;  de Vos, M;  Papadimitriou, K;  Thorburn, D;  O'Beirne, J;  Patch, D;  Pinzani, M;  Morgan, MY;  Agarwal, B;  Yu, D;  Burroughs, AK;  Tsochatzis, EA;   - view fewer <#>    (2017)    Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score.                   Journal of Cachexia, Sarcopenia and Muscle , 8  (1)   pp. 113-121.    10.1002/jcsm.12095 <https://doi.org/10.1002/jcsm.12095>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1476377/1/Kalafateli_et_al-2016-Journal_of_Cachexia%2C_Sarcopenia_and_Muscle%20epub.pdf