Impact of Skeletal Muscle Loss and Functional Deconditioning on Outcomes in Hepatic Resection and Liver Transplantation: A Review

Randeep Kashyap and M. Katherine Dokus

Department of Surgery, Division of Solid Organ Transplantation, University of Rochester Medical Center, USA

^*Correspondance to: Randeep Kashyap 

 PDF  Full Text DOI: 10.25107/2474-1647.1258

Abstract

A growing number of older and sicker patients are being offered surgical intervention for their ailments. The effects of frailty and sarcopenia, syndromes characterized by loss of muscle mass and functional reserve are more prevalent in this population, and operative outcomes are just beginning to be elucidated. Here, we provide a review of published reports on mortality, morbidity and resource utilization in liver transplant and hepatectomy on frail and/or sarcopenic adults. Fourteen studies were selected for review; 82% of analyses reporting described greater resource utilization (e.g. length of stay, readmissions) in the frail cohort, 80% demonstrated increased rates of morbidity. The majority of included studies (69%) reported higher mortality in the debilitated groups undergoing liver transplant or hepatectomy with hazard of death ranging from 1.05-26.4. Though the preponderance of studies pointed to worse outcomes for frail or sarcopenic patients; lack of uniformity on the operational definition of these concepts makes generalization and clinical application difficult. A validated, practicable measure can help surgical teams identify candidates at greater risk of poor outcomes and implement interventions to reduce such hazards.

Keywords

Frail; Sarcopenia; Liver transplantation; Liver surgery; Outcomes

Cite the article

Kashyap R, Katherine Dokus M. Impact of Skeletal Muscle Loss and Functional Deconditioning on Outcomes in Hepatic Resection and Liver Transplantation: A Review. Clin Surg. 2016; 1: 125.