Sarcopenia was associated with waiting list mortality in liver transplant candidates with cirrhosis, particularly in patients with lower MELD scores. A model including all these variables yielded a c-index of 0.851. Apart from sarcopenia and MELD score, other predictive variables were occurrence of hepatic encephalopathy before listing and recipient age. The discriminative performance of the MELD-Sarcopenia score (c-index 0.820) for three-month mortality was lower than MELD score alone (c-index 0.839). This effect was even more pronounced in patients with MELD ≤15. Median waiting list survival was shorter in patients with sarcopenia than those without (p <0.001). We included 585 patients with a median MELD score of 14 (interquartile range 9-19), of which 254 (43.4%) were identified as having sarcopenia. We created a nomogram of the best predictive model. A competing risk analysis was used to compare survival of patients with and without sarcopenia, and concordance (c) indices were calculated to assess performance of the MELD and MELD-Sarcopenia score. We identified consecutive patients with cirrhosis listed for liver transplantation in the Eurotransplant registry between 2007-2014 and measured skeletal muscle mass on computed tomography. We aimed to investigate the association between sarcopenia and waiting list mortality, and to validate the MELD-Sarcopenia score (i.e. A recent study proposed incorporating sarcopenia in the MELD score (MELD-Sarcopenia score). Low skeletal muscle mass, namely sarcopenia, has been identified as a risk factor for waiting list mortality. 9 Department of Gastroenterology and Hepatology, University of Groningen University Medical Centre Groningen, Groningen, the Netherlands.įrail patients with low model for end-stage liver disease (MELD) scores may be under-prioritised.8 Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands.7 Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.6 Department of Radiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.5 Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands.4 Department of Dietetics, Leiden University Medical Centre, Leiden, the Netherlands.3 Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.Electronic address: 2 Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands. ![]() 1 Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
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