Health care providers need to be on the lookout for muscle wasting in their patients with advanced liver disease, particularly when assessing where they need to be placed on transplant lists, according to a new report published in Clinical Gastroenterology and Hepatology.
This conclusion comes from a study in which researchers at the University of Alberta, under the direction of Michael Sawyer, MD, reviewed the medical records of more than 100 patients who had cirrhosis and were placed on the national liver transplant list. Sawyer’s team found that those who were losing muscle were more likely to die while awaiting surgery.
These cirrhosis patients, the researchers found, were placed at a lower spot on the transplant list because they had a higher functioning liver and were seemingly less sick than others with the same condition, based on scoring systems health care providers commonly use today.
Sawyer’s group studied 112 patients with cirrhosis who were awaiting liver transplants at the University of Alberta Hospital and discovered 40 percent of them had muscle wasting or low muscle mass. Those with low muscle mass lived for about 19 months if they couldn’t get a transplant, while those with normal muscle mass lived for about 34 months without a liver transplant.
“Patients with cirrhosis who have low muscle mass are actually more sick than what current scoring systems are telling us, and many of them die while waiting on the liver transplant lists,” said Sawyer in an accompanying news announcement. “Patients with low muscle mass will get put on the list thinking they can wait for around three years, but really they can only wait for about one-and-a-half years.”
Sawyer adds: “Those in the medical field have been looking for better methods to assess patients with cirrhosis, and this may be that missing piece to the puzzle. If we can combine this measure of muscle mass with the current scoring system, it will provide a better way of predicting survival rates of patients awaiting liver transplants.”