Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
Department of Emergency, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
World J Gastroenterol. 2024 Feb 28;30(8):956-968. doi: 10.3748/wjg.v30.i8.956.
The prevalence of sarcopenia in patients undergoing liver transplantation (LT) remains to be determined partly because of different diagnostic criteria. Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates.
To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates.
This systematic search was conducted in PubMed, Web of Science, Embase, and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30, 2022. Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included.
Twenty-five studies involving 7760 patients undergoing LT were included. The pooled prevalence of sarcopenia in patients undergoing LT was 40.7% [95% confidence intervals (95%CI): 32.1-49.6]. The 1-, 3-, and 5-year cumulative probabilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia ( < 0.05). Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT (adjusted hazard ratio: 1.58; 95%CI: 1.21-2.07). Patients with preoperative sarcopenia had a longer intensive care unit stay, a high risk ratio of sepsis, and serious post-LT complications than those without sarcopenia.
Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.
由于不同的诊断标准，接受肝移植（LT）的患者中肌少症的患病率仍有待确定。肌少症最近被认为是预测 LT 候选者预后的新的预后因素。
估计肌少症的患病率，并评估其对 LT 候选者的临床影响。
本系统检索了 PubMed、Web of Science、Embase 和 Cochrane Library 中从数据库建立到 2022 年 11 月 30 日的原始英文文献，以调查 LT 患者肌少症的患病率及其对临床结局和死亡率风险的影响。纳入了估计肌少症患病率并评估其对临床结局影响的肌少症定义的队列研究。
共纳入 25 项研究，涉及 7760 例接受 LT 的患者。LT 患者肌少症的总体患病率为 40.7%（95%置信区间：32.1-49.6）。术前肌少症患者的 LT 后 1、3 和 5 年累积生存率均低于无肌少症患者（<0.05）。肌少症与 LT 患者的 LT 后死亡率风险增加相关（调整后的危险比：1.58；95%置信区间：1.21-2.07）。与无肌少症患者相比，术前肌少症患者 ICU 停留时间更长，发生脓毒症的风险比更高，并且 LT 后严重并发症更多。
肌少症在接受 LT 的患者中很常见，且与更高的死亡率风险密切相关。
