Liver frailty and impact of liver transplants on transplanted patients’ health

Fernandez-Alonso, Victor; Hernandez-Matias, Ana Maria; Perez-Gomez, Manuela; Rodriguez-Leal, Leyre; Moro-Tejedor, Maria Nieves

doi:10.1590/1518-8345.7330.4563

person Victor Fernandez-Alonso

Substantial contributions to the conception or design of the work · Acquisition, analysis, or interpretation of data for the work · Drafting the work or reviewing it critically for important intellectual content · Final approval of the version to be published · Agreement to be accountable for all aspects of the work · Data curation · Project supervision and management

schoolInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainschoolUniversidad Autónoma de Madrid, Escuela Universitaria de Enfermeria de Cruz Roja, Madrid, Spain

0000-0002-4018-9931

person Ana Maria Hernandez-Matias

Substantial contributions to the conception or design of the work · Acquisition, analysis, or interpretation of data for the work · Drafting the work or reviewing it critically for important intellectual content · Final approval of the version to be published · Agreement to be accountable for all aspects of the work

schoolHospital General Universitario Gregorio Marañon, Madrid, Spain

0000-0002-8947-7221

person Manuela Perez-Gomez

Substantial contributions to the conception or design of the work · Acquisition, analysis, or interpretation of data for the work · Drafting the work or reviewing it critically for important intellectual content · Final approval of the version to be published · Agreement to be accountable for all aspects of the work · Project supervision and management

schoolHospital General Universitario Gregorio Marañon, Madrid, Spain

0009-0007-3587-2975

person Leyre Rodriguez-Leal

Substantial contributions to the conception or design of the work · Acquisition, analysis, or interpretation of data for the work · Drafting the work or reviewing it critically for important intellectual content · Final approval of the version to be published · Agreement to be accountable for all aspects of the work

schoolUniversidad Autónoma de Madrid, Escuela Universitaria de Enfermeria de Cruz Roja, Madrid, Spain

0000-0003-3568-7204

person Maria Nieves Moro-Tejedor

Substantial contributions to the conception or design of the work · Acquisition, analysis, or interpretation of data for the work · Drafting the work or reviewing it critically for important intellectual content · Final approval of the version to be published · Agreement to be accountable for all aspects of the work · Data curation · Project supervision and management

schoolInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainschoolHospital General Universitario Gregorio Marañon, Madrid, Spain

0000-0002-2677-7454

personCorresponding author: Victor Fernandez-Alonso E-mail:
victorferal@hotmail.com

Conflict of interest:

the authors have declared that there is no conflict of interest.

Associate Editor:

Karina Dal Sasso Mendes

Pre-LT* variable (n ^† =51)	Global n ^† (%)	LFI ^‡ x̅ ^§ (SD ^\|\| )	Sig ^¶ (p-value)
Gender
Male	38 (74.5%)	3.72 (0.81)	0.897
Female	13 (25.5%)	3.67 (0.50)
Marital status
With a partner	37 (72.5%)	3.74 (0.66)	0.533
No partner	14 (27.5%)	3.62 (0.95)
Schooling level
High School or lower	25 (49%)	3.80 (0.59)	0.371
Higher Education	26 (51%)	3.62 (0.86)
Work situation
Active	36 (70.6%)	3.85 (0.69)	0.014
Not active	15 (29.4%)	3.67 (0.76)
Religion
Professes no religion	18 (35.3%)	3.80 (0.94)	0.315
Professes some religion	33 (64.7%)	3.66 (0.62)
Diabetes mellitus
Yes	18 (35.3%)	3.95 (0.59)	0.119
No	33 (64.7%)	3.52 (0.79)
Arterial hypertension
Yes	19 (37.3%)	3.74 (0.78)	0.876
No	32 (62.7%)	3.69 (0.73)
Dyslipidaemia
Yes	14 (27.5%)	4.02 (0.80)	0.069
No	37 (72.5%)	3.59 (0.69)
Smoking habit
Smoker	10 (19.6%)	3.66 (0.85)	0.822
Non-smoker	41 (80.4%)	3.72 (0.85)
Etiology
ARLD**	19 (37.3%)	3.98 (0.57)	0.039
Not ARLD**	32 (62.7%)	3.55 (0.79)

*LT (n^†=51** )		Age	BMI ^‡	MELD-Na ^§	HAS ^\|\|	HDS ^¶	LFI**
Age	r	1	0.058	-0.197	-0.208	-0.323 ^††	0.268
Age	p-value		0.686	0.166	0.142	0.021	0.057
BMI ^‡	r	0.058	1	0.091	-0.123	0.071	0.030
BMI ^‡	p-value	0.686		0.524	0.390	0.622	0.835
MELD-Na ^§	r	-0.197	0.091	1	0.187	0.315 ^††	0.392 ^‡‡
MELD-Na ^§	p-value	0.166	0.524		0.188	0.024	0.004
HAS ^\|\|	r	-0.208	-0.123	0.187	1	0.570 ^‡‡	-0.008
HAS ^\|\|	p-value	0.142	0.390	0.188		<0.001	0.957
HDS ^¶	r	-0.323 ^††	0.071	0.315 ^††	0.570 ^‡‡	1	0.098
HDS ^¶	p-value	0.021	0.622	0.024	<0.001		0.495
LFI**	r	0.268	0.30	0.391 ^‡‡	-0.008	0.098	1
LFI**	p-value	0.057	0.835	0.004	0.957	0.495

	Pre-LT* (%, SD ^‡ )	Post-LT ^† (%, SD ^‡ )	Statistical value	Sig ^§ (p-value)
Diabetes mellitus
Yes	18 (35.29%)	29 (56.86%)	-3,065	0.007 ^\|\|
No	33 (64.71%)	22 (43.14%)
Arterial hypertension
Yes	19 (37.25%)	33 (64.71%)	-3.253	0.004 ^\|\|
No	32 (62.75%)	18 (35.29%)
Dyslipidaemia
Yes	14 (27.45%)	16 (31.37%)	-0,496	0.804
No	37 (72.55%)	35 (68.63%)
Smoker
Yes	10 (19.6%)	5 (9.8%)	1.940	0.058
No	41 (80.4%)	46 (90.2%)
LFI ^¶	3.71 (SD 0.74)	3.39 (SD 0.77)	3.764	<0.001**
MELD-Na ^††	15.04 (SD 6.36)	9.05 (SD 3.07)	6.041	<0.001**
BMI ^‡‡	28.07 (SD 4.91)	26.82 (SD 5.57)	2.170	0.035**
HAS ^§§	6.49 (SD 3.82)	4.94 (SD 3.67)	3.257	0.002**
HDS ^\|\|\|\|	4.43 (SD 3.59)	3.14 (SD 3.58)	2.520	0.015**

LT* (n ^† =51)		Age	BMI ^‡	MELD-Na ^§	HAS ^\|\|	HDS ^¶	LFI**
Age	r	1	-0.098	0.232	-0.367 ^††	-0.221	0.343 ^‡‡
Age	p-value		0.495	0.101	0.008	0.119	0.014
BMI ^‡	r	-0.098	1	-0.044	-0.061	0.068	-0.127
BMI ^‡	p-value	0.495		0.761	0.672	0.636	0.373
MELD-Na ^§	r	0.232	-0.044	1	-0.117	-0.260	0.287 ^‡‡
MELD-Na ^§	p-value	0.101	0.761		0.414	0.065	0.041
HAS ^\|\|	r	-0.367 ^††	-0.061	-0.117	1	0.528 ^††	-0.136
HAS ^\|\|	p-value	0.008	0.672	0.414		<0.001	0.341
HDS ^¶	r	-0.221	0.068	-0.260	0.528 ^††	1	0.146
HDS ^¶	p-value	0.119	0.636	0.065	<0.001		0.308
LFI**	r	0.343 ^‡‡	-0.127	0.287 ^‡‡	-0.136	0.146	1
LFI**	p-value	0.014	0.373	0.041	0.341	0.308

Variable	Inclusion in liver transplant waiting list						One year after liver transplant
Variable	Regression Coefficient (β)	Standard Error	z*	Odds Ratio (95% Confidence Interval)	Sig ^† (p-value)	Regression Coefficient (β)	Standard Error	z*	Odds Ratio (95% Confidence Interval)	Sig ^† (p-value)
MELD-Na ^‡	0.270	0.113	2.39	1.309 (1.050 – 1.633)	0.017	0.213	0.156	1.69	1.237 (0.966 – 1.584)	0.043
Time in waiting list (days)	0.011	0.005	2.03	1.010 (1.000 – 1.021)	0.042	0.007	0.003	1.85	1.006 (0.999 – 1.013)	0.064
ARLD ^§	1.577	1.179	1.34	4.841 (0.480 – 48.832)	0.181	1.564	3.581	2.03	4.694 (1.052 – 20.941)	0.091
Constant	-3.634	1.673	-2.17	0.026 (0.001 – 0.701)	0.030	-2.518	0.110	-1.84	0.080 (0.005 – 1.183)	0.066

[1] *Pre-LT = Before liver transplant; ^†n = Sample size; ^‡LFI = Liver Frailty Index; ^§x̅ = Mean value; ^||SD = Standard Deviation; ^¶Sig (p-value) = Mann-Whitney’s U statistical significance; **ARLD = Alcohol-Related Liver Disease

Liver frailty and impact of liver transplants on transplanted patients’ health

Highlights: