Pre-transplant Sarcopenic Obesity Worsens the Survival After Liver Transplantation: A Meta-Analysis and a Systematic Review

Frontiers in Medicine

article

Péter Jenö Hegyi¹  Bálint Eröss¹  Gabriella Pár²  Alexandra Soós¹  Péter Hegyi¹  Zsolt Szakács¹  Lilla Hanák¹  Szilárd Váncsa¹  Klementina Ocskay¹  Erika Pétervári¹  Márta Balaskó¹ 

[1] Institute for Translational Medicine, Medical School, University of Pécs;Clinical Medicine Doctoral School, University of Szeged;Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs;Szentágothai Research Centre, University of Pécs

关键词: non-alcoholic steatohepatitis;    sarcopenic obesity;    liver transplantation;    body composition;    non-alcoholic fatty liver disease;   

DOI  :  10.3389/fmed.2020.599434

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The rising prevalence of cirrhotic cases related to non-alcoholic steatohepatitis has led to an increased number of cirrhotic patients with coexistence of obesity and muscle mass loss, known as sarcopenic obesity (SO). In patients undergoing liver transplantation (LT), the presence of SO may worsen prognosis, and increase morbidity and mortality. Objective: We aimed to evaluate the effect of the presence of pre-transplant SO on the outcomes of LT. Methods: A comprehensive search was performed in seven medical databases for studies comparing morbidity and mortality of patients with and without SO after LT. The primary outcome was overall mortality in the short- (1 year), intermediate- (3 years), and long- (5 years) term. We calculated pooled relative risks (RRs) with 95% confidence intervals (CIs). Heterogeneity was quantified with I 2 -statistics. Results: Based on the analysis of 1,515 patients from three articles, SO increased overall mortality compared to non-SO at short-, intermediate-, and long-term follow-up (RR = 2.06, 95% CI: 1.28-3.33; RR = 1.67, 95% CI: 1.10-2.51; and RR = 2.08, 95% CI: 1.10-3.93, respectively) without significant between-study heterogeneity for the short- and intermediate- term (I 2 = 0.0% for both) and considerable heterogeneity for long-term follow-up (I 2 = 81.1%). Conclusion: Pre-transplant SO proved to be a risk factor after LT and was associated with two times higher mortality at short- and long- term follow-up. Since SO worsens the prognosis of patients after LT, the inclusion of body composition assessment before LT may help to plan a more individualized nutritional treatment, physiotherapy, and postoperative care and may improve morbidity and mortality.

【 授权许可】

CC BY