Effect of frailty as measured by functional impairment on long-term outcomes in liver transplantation in the United States  

作　　者：Julius Balogh Talha Mubashir Yuan Li Biai D Digbeu Nikita Hegde Fatemeh Movaghari Pour Mohsen Rezapour Hong-Yin Lai Kelly West Rabail A Chaudhry George W Williams Vahed Maroufy 

机构地区：[1]Department of CV Anesthesia,CHI St.Vincent Infirmary,Little Rock,AR 72205,United States [2]Department of Biostatistics and Data Science,The University of Texas Health Center at Houston School of Public Health,Houston,TX 77030,United States [3]Department of Anesthesiology and Pain Medicine,University of Washington,Seattle,WA 98195,United States [4]Department of Comprehensive Dentistry,UT Health San Antonio School of Dentistry,San Antonio,TX 78229,United States [5]Vertex Pharmaceuticals,Boston,MA 02210,United States [6]Department of Anesthesiology,Critical Care and Pain Medicine,The University of Texas Health Science Center at Houston McGovern Medical School,Houston,TX 77030,United States [7]Department of Anesthesiology and Pain Medicine,University of Arizona College of Medicine-Tucson,Tucson,AZ 85724,United States

出　　处：《World Journal of Transplantation》2025年第2期205-217,共13页世界移植杂志(英文)

摘　　要：BACKGROUND In patients with chronic liver disease or hepatic dysfunction with sarcopenia,there is an increased risk of frailty as measured by functional impairment,making frailty a vital predictor of post-transplant mortality.AIM To investigate the effects of frailty on mortality after liver transplantation.METHODS A retrospective review of post-transplant outcomes in liver transplant recipients assessed frailty using Karnofsky Performance Score.Data from the Scientific Registry of Transplant Recipients database for 37427 liver transplant recipients was used.RESULTS Of 82.7%frail patients,42.7%were severely frail and 40%were moderately frail(P<0.001)at the time of transplantation.Compared with non-frail patients,post-transplant mortality in frail patients was significantly higher at 12 months[odds ratio(OR)=1.94,P=0.02].Secondary analysis of the data revealed that liver grafts from donation after circulatory death(DCD)were more likely to be associated with frail patients at transplant(OR=1.86,P<0.001).Furthermore,a donor history of hypertension was associated with a lower likelihood of frailty in the recipient at the time of transplant(OR=0.65,P=0.03).CONCLUSION Recipient frailty is associated with increased mortality at 12 months following liver transplantation,and liver transplants from donors with DCD are associated with increased frailty of the liver transplant recipient.

关 键 词：Non-alcoholic steatotic liver disease Alcohol-associated liver disease Liver transplantation Non-alcoholic steatohepatitis Insulin resistance Oxidative stress 

分 类 号：R657.3[医药卫生—外科学]