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Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes
Sarcopenia is a clinical condition characterized by a reduction in muscle mass, which typically affects adult patients; however, it has recently been recognized in pediatric literature. Few studies in children with chronic liver disease (CLD) undergoing liver transplantation (LT) have investigated t...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891232/ https://www.ncbi.nlm.nih.gov/pubmed/36741094 http://dx.doi.org/10.3389/fped.2022.1033570 |
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author | Veraldi, Silvio Pietrobattista, Andrea Soglia, Giovanna Monti, Lidia Alterio, Tommaso Mosca, Antonella Liccardo, Daniela Basso, Maria Sole Della Corte, Claudia Russo, Luca Candusso, Manila Chiusolo, Fabrizio Tortora, Francesca Spada, Marco Maggiore, Giuseppe |
author_facet | Veraldi, Silvio Pietrobattista, Andrea Soglia, Giovanna Monti, Lidia Alterio, Tommaso Mosca, Antonella Liccardo, Daniela Basso, Maria Sole Della Corte, Claudia Russo, Luca Candusso, Manila Chiusolo, Fabrizio Tortora, Francesca Spada, Marco Maggiore, Giuseppe |
author_sort | Veraldi, Silvio |
collection | PubMed |
description | Sarcopenia is a clinical condition characterized by a reduction in muscle mass, which typically affects adult patients; however, it has recently been recognized in pediatric literature. Few studies in children with chronic liver disease (CLD) undergoing liver transplantation (LT) have investigated the role of sarcopenia, with controversial results. The aim of our study was to assess the prevalence and impact of sarcopenia among children with CLD who are candidates for LT. We conducted a retrospective, single-center study at Bambino Gesù Children's Hospital (Rome, Italy) from July 2016 to July 2021, evaluating all children (0–16 years old) with CLD listed for LT with an abdomen computed tomography imaging available before LT. The total psoas muscle surface area (t-PMSA) was defined as the sum of left and right psoas muscle surface area measured at L4–L5 on axial images. The t-PMSA z-score was calculated according to reference data, and sarcopenia was defined as a t-PMSA z-score of ≤−2 (1–16 years) or a psoas muscle index [PMI; PMI = t-PMSA/(100 × BSA)] of <50th percentile of the population examined (<1 year). Clinical, laboratory, and LT outcome data were collected from all the patients with CLD. 27 out 48 (56%) of the patients aged 1–16 years were sarcopenic. No differences were noted in anthropometrics, nutritional support, liver function tests, model for ESLD (MELD), or pediatric ESLD (PELD) scores between patients with and without sarcopenia. The former showed a higher prevalence of respiratory complications (66.7% vs. 42.1%) and need for inotropes (40.7% vs. 10.8%) after LT. Among patients aged 0–1 years (n: 36), those with reduced muscle mass (50%) had a longer hospitalization time (44 vs. 24 days) and higher incidences of multi-organ failure syndrome (38.9% vs. 0%) and intensive care unit-related infections (61.1% vs. 27.8%) compared to those with greater muscle mass. t-PMSA and PMI were statistically significant predictors of LT outcomes. Sarcopenia is a reliable index of frailty in children with CLD, as its presence is associated with the risk of a more challenging LT. Future studies will have to investigate the functional aspects of sarcopenia and conceive preventive measures of muscle wasting in CLD patients. |
format | Online Article Text |
id | pubmed-9891232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98912322023-02-02 Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes Veraldi, Silvio Pietrobattista, Andrea Soglia, Giovanna Monti, Lidia Alterio, Tommaso Mosca, Antonella Liccardo, Daniela Basso, Maria Sole Della Corte, Claudia Russo, Luca Candusso, Manila Chiusolo, Fabrizio Tortora, Francesca Spada, Marco Maggiore, Giuseppe Front Pediatr Pediatrics Sarcopenia is a clinical condition characterized by a reduction in muscle mass, which typically affects adult patients; however, it has recently been recognized in pediatric literature. Few studies in children with chronic liver disease (CLD) undergoing liver transplantation (LT) have investigated the role of sarcopenia, with controversial results. The aim of our study was to assess the prevalence and impact of sarcopenia among children with CLD who are candidates for LT. We conducted a retrospective, single-center study at Bambino Gesù Children's Hospital (Rome, Italy) from July 2016 to July 2021, evaluating all children (0–16 years old) with CLD listed for LT with an abdomen computed tomography imaging available before LT. The total psoas muscle surface area (t-PMSA) was defined as the sum of left and right psoas muscle surface area measured at L4–L5 on axial images. The t-PMSA z-score was calculated according to reference data, and sarcopenia was defined as a t-PMSA z-score of ≤−2 (1–16 years) or a psoas muscle index [PMI; PMI = t-PMSA/(100 × BSA)] of <50th percentile of the population examined (<1 year). Clinical, laboratory, and LT outcome data were collected from all the patients with CLD. 27 out 48 (56%) of the patients aged 1–16 years were sarcopenic. No differences were noted in anthropometrics, nutritional support, liver function tests, model for ESLD (MELD), or pediatric ESLD (PELD) scores between patients with and without sarcopenia. The former showed a higher prevalence of respiratory complications (66.7% vs. 42.1%) and need for inotropes (40.7% vs. 10.8%) after LT. Among patients aged 0–1 years (n: 36), those with reduced muscle mass (50%) had a longer hospitalization time (44 vs. 24 days) and higher incidences of multi-organ failure syndrome (38.9% vs. 0%) and intensive care unit-related infections (61.1% vs. 27.8%) compared to those with greater muscle mass. t-PMSA and PMI were statistically significant predictors of LT outcomes. Sarcopenia is a reliable index of frailty in children with CLD, as its presence is associated with the risk of a more challenging LT. Future studies will have to investigate the functional aspects of sarcopenia and conceive preventive measures of muscle wasting in CLD patients. Frontiers Media S.A. 2022-10-18 /pmc/articles/PMC9891232/ /pubmed/36741094 http://dx.doi.org/10.3389/fped.2022.1033570 Text en © 2022 Veraldi, Pietrobattista, Soglia, Monti, Alterio, Mosca, Liccardo, Basso, Della Corte, Russo, Candusso, Chiusolo, Tortora, Spada and Maggiore. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Veraldi, Silvio Pietrobattista, Andrea Soglia, Giovanna Monti, Lidia Alterio, Tommaso Mosca, Antonella Liccardo, Daniela Basso, Maria Sole Della Corte, Claudia Russo, Luca Candusso, Manila Chiusolo, Fabrizio Tortora, Francesca Spada, Marco Maggiore, Giuseppe Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title | Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title_full | Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title_fullStr | Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title_full_unstemmed | Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title_short | Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes |
title_sort | sarcopenia in children with chronic liver disease: prevalence and impact on liver transplant outcomes |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891232/ https://www.ncbi.nlm.nih.gov/pubmed/36741094 http://dx.doi.org/10.3389/fped.2022.1033570 |
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