4.2 Review

Assessing nutrition status, sarcopenia, and frailty in adult transplant recipients

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Iron deficiency and cognitive functioning in kidney transplant recipients: findings of the TransplantLines biobank and cohort study

Joanna Sophia J. Vinke et al.

Summary: This study investigated iron deficiency as a potentially modifiable risk factor for cognitive impairment in kidney transplant recipients (KTRs). The results showed that iron deficiency was associated with lower scores in memory, mental speed, and attention and executive functioning. Therefore, iron deficiency may be an important factor in cognitive impairment after kidney transplantation.

NEPHROLOGY DIALYSIS TRANSPLANTATION (2023)

Article Nutrition & Dietetics

Association between GLIM-defined malnutrition and hospitalizations in kidney transplant candidates: A post hoc analysis of a cohort study

Vanesa Davalos-Yerovi et al.

Summary: The study aimed to evaluate the value of the Global Leadership Initiative for Malnutrition (GLIM) criteria in predicting hospitalizations and mortality in kidney transplant candidates during their first year on the waiting list. The results showed that malnutrition according to the GLIM criteria was prevalent in patients with chronic kidney disease (CKD) and was associated with a threefold increased risk of hospitalizations during the first year on the waiting list.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2023)

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The role of bioelectrical phase angle in patients with heart failure

Pietro Scicchitano et al.

Summary: The evaluation of congestion in heart failure (HF) is the most challenging feature. Bioimpedance vector analysis (BIVA) and the biomarker, Bioelectrical Phase Angle (PhA), have shown potential in assessing congestion status and managing HF patients.

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Regional changes in intestinal permeability in cirrhosis are associated with mucosal bacteria

Patricia P. Bloom et al.

Summary: Patients with cirrhosis have higher duodenal epithelial permeability and lower mucosal bacteria alpha diversity compared to controls, while no such differences are seen in the ileum or colon. Specific bacteria are associated with epithelial permeability and future hepatic decompensation.

HEPATOLOGY COMMUNICATIONS (2023)

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Different combinations of the GLIM criteria for patients awaiting a liver transplant: Poor performance for malnutrition diagnosis but a potentially useful prognostic tool

Barbara Chaves Santos et al.

Summary: This study assessed the impact of malnutrition according to the GLIM criteria on the outcomes of patients awaiting liver transplant and compared these criteria with Subjective Global Assessment. The majority of GLIM combinations had poor agreement with SGA, and 4 of the 36 GLIM combinations were independently associated with adverse outcomes.

CLINICAL NUTRITION (2022)

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Frailty, mortality, and health care utilization after liver transplantation: From the Multicenter Functional Assessment in Liver Transplantation (FrAILT) Study

Jennifer C. Lai et al.

Summary: Frail patients who undergo liver transplantation have a higher risk of post-transplantation death and increased healthcare utilization compared to nonfrail patients. Targeting pre-transplant frailty may improve post-transplant outcomes and reduce resource utilization.

HEPATOLOGY (2022)

Review Nutrition & Dietetics

Role of the nutrition-focused physical examination in identifying malnutrition and its effectiveness

A. Christine Hummell et al.

Summary: It is well established that malnutrition can alter physical appearance and reduce physical activity. The Subjective Global Assessment tool is considered the gold standard for nutrition assessment, while the nutrition-focused physical examination provides a comprehensive evaluation method. Standardized criteria for malnutrition diagnosis help in accurate diagnosis and treatment.

NUTRITION IN CLINICAL PRACTICE (2022)

Article Urology & Nephrology

Presence of Sarcopenia before Kidney Transplantation Is Associated with Poor Outcomes

Ido Druckmann et al.

Summary: Muscle size and quality measurements are associated with post-kidney transplantation outcomes and should be included in the assessment of kidney transplantation candidates.

AMERICAN JOURNAL OF NEPHROLOGY (2022)

Article Surgery

Predictive value of chart-based frailty evaluation for lung transplant candidates

Serina Gee et al.

Summary: Frailty is correlated with poorer outcomes in lung transplant patients, and early intervention and close follow-up may benefit frail patients.

CLINICAL TRANSPLANTATION (2022)

Article Geriatrics & Gerontology

Frailty and solid-organ transplant candidates: a scoping review

Jonathan Kao et al.

Summary: The study found a wide range of variability in the approach to frailty measurement in solid-organ transplant candidates. It is suggested that a validated frailty measurement tool be incorporated internationally to facilitate comparisons between patient sub-groups and transplant services, ultimately aiming to improve patient care.

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Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Qin Ding et al.

Summary: This study analyzed the nutritional status of lung transplant recipients and its correlation with short-term prognosis. The results showed that lung transplant recipients have a higher incidence of nutritional risk and malnutrition, which is associated with short-term prognosis indicators such as drainage volume, length of stay, and hospitalization costs.

ANNALS OF TRANSLATIONAL MEDICINE (2022)

Article Geriatrics & Gerontology

Muscle mass, muscle strength and mortality in kidney transplant recipients: results of the TransplantLines Biobank and Cohort Study

Iris M. Y. van Vliet et al.

Summary: Muscle mass and muscle strength have an impact on the survival rate of kidney transplant recipients, but different measurement methods may lead to different results; routine assessment using both 24-hour urine samples and hand grip strength is recommended to improve muscle status.

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Article Education, Scientific Disciplines

Teaching the Nutrition Focused Physical Exam (NFPE) To Medical Students Using an Interdisciplinary Approach

Stephanie R. Harris et al.

Summary: Nutritional status has a significant impact on patient health, but medical school curricula often lack proper nutrition education. This study implemented a new teaching method by using the Nutrition Focused Physical Exam (NFPE) to emphasize the importance of evaluating patients' nutritional status and learning about malnutrition and nutrient deficiencies.

MEDICAL SCIENCE EDUCATOR (2022)

Article Oncology

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Qin Ding et al.

Summary: This retrospective cohort study analyzed the nutritional status of lung transplant recipients in 2020 at Shanghai Pulmonary Hospital and found a high incidence of nutritional risk and malnutrition among them, which significantly affected their short-term prognosis.

ANNALS OF TRANSLATIONAL MEDICINE (2022)

Article Cardiac & Cardiovascular Systems

Frailty Screening Tool for Patients Undergoing Orthotopic Heart Transplant

Laura Seese et al.

Summary: A study developed and validated an OHT frailty screening tool, finding that frail patients had higher rates of mortality, complications, and longer hospital stays post-transplant. The screening tool showed high predictive value for adverse post-transplant outcomes.

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Article Gastroenterology & Hepatology

Identifying an Optimal Liver Frailty Index Cutoff to Predict Waitlist Mortality in Liver Transplant Candidates

Ani Kardashian et al.

Summary: The study found that LFI can predict waitlist mortality across a wide range of values, with optimal LFI cutoffs at different time points. Combining LFI with MELDNa improves predictive performance compared to using MELDNa alone.

HEPATOLOGY (2021)

Article Cardiac & Cardiovascular Systems

Nutritional Risk Index: A Predictive Metric for Mortality After Lung Transplant

Benjamin Bigelow et al.

Summary: This study assessed the impact of pre-transplant nutritional status on outcomes in lung transplant patients. It found that patients with severe malnutrition had higher postoperative mortality rates and longer hospital stays.

ANNALS OF THORACIC SURGERY (2021)

Article Gastroenterology & Hepatology

Phase Angle From Bioelectrical Impedance for the Assessment of Sarcopenia in Cirrhosis With or Without Ascites

Astrid Ruiz-Margain et al.

Summary: PhA in cirrhotic patients moderately correlates with SMI for the identification of sarcopenia. Its prognostic accuracy is comparable to SMI and is not influenced by ascites.

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Article Surgery

Karnofsky performance status predicts outcomes in candidates for simultaneous liver-kidney transplant

Hani Shamseddeen et al.

Summary: The Karnofsky performance status (KPS) is associated with waitlist and post-transplant mortality in simultaneous liver-kidney transplantation (SLKT) recipients and registrants.

CLINICAL TRANSPLANTATION (2021)

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Decreased Nutritional Risk Index is associated with mortality after heart transplantation

Aravind Krishnan et al.

Summary: This study analyzed 25,236 adult heart transplant patients from the UNOS database and found that moderate-to-severe malnutrition was associated with increased mortality and post-transplant dialysis. Malnutrition determined by NRI can serve as an important indicator of preoperative patient condition.

CLINICAL TRANSPLANTATION (2021)

Article Cardiac & Cardiovascular Systems

The impact of frailty on mortality after heart transplantation

Peter S. Macdonald et al.

Summary: Pre-transplant frailty is independently associated with increased post-transplant mortality and prolonged hospitalization, with lower survival rates and longer hospital stays in the frail cohort.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2021)

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Assessment of the Frail Patient With End-Stage Liver Disease: A Practical Overview of Sarcopenia, Physical Function, and Disability

Felicity R. Williams et al.

Summary: Frailty is a significant predictor of clinical outcomes in patients with end-stage liver disease, and it is crucial for all patients in this population to undergo frailty assessments. Various tools have emerged in recent years for assessing frailty, with a combination of measures recommended for identifying frailty and assessing specific aspects such as sarcopenia and physical function.

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Michelle Kozeniecki et al.

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Association of sarcopenia with phase angle and body mass index in kidney transplant recipients

Akihiro Kosoku et al.

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Frailty as Tested by Gait Speed Is a Risk Factor for Liver Transplant Respiratory Complications

Tariq Salim et al.

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Changes in frailty are associated with waitlist mortality in patients with cirrhosis

Jennifer C. Lai et al.

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Iron metabolism imbalance at the time of listing increases overall and infectious mortality after liver transplantation

Elodie Fallet et al.

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A scoping review of the Clinical Frailty Scale

Sophie Church et al.

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Frailty Prevalence in Younger End-Stage Kidney Disease Patients Undergoing Dialysis and Transplantation

Nadia M. Chu et al.

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Sarcopenia: revised European consensus on definition and diagnosis

Alfonso J. Cruz-Jentoft et al.

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Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

E. Dent et al.

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Report from the American Society of Transplantation on frailty in solid organ transplantation

Jon Kobashigawa et al.

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Ha Thanh Nguyen et al.

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