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World J Transplant. Jun 18, 2024; 14(2): 90202
Published online Jun 18, 2024. doi: 10.5500/wjt.v14.i2.90202
Sarcopenic obesity in patients awaiting liver transplant: Unique challenges for nutritional recommendations
Darya M Herscovici, Katherine M Cooper, Alessandro Colletta, Michelle Rightmyer, Alexandra Shingina, Lauren D Feld
Darya M Herscovici, Katherine M Cooper, Alessandro Colletta, Lauren D Feld, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, United States
Michelle Rightmyer, Division of Transplant Nutrition, UMass Chan Medical School, Worcester, MA 01655, United States
Alexandra Shingina, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37215, United States
Lauren D Feld, Division of Gastroenterology, UMass Chan Medical School, Worcester, MA 01655, United States
Author contributions: Herscovici DM formulated the scope of this review and led writing; Cooper KM, Colletta A contributed to writing sections of the manuscript; Rightmyer M, Shingina A and Feld LD provided expert review of this subject matter; Herscovici DM, Cooper KM, Colletta A, Rightmyer M, Shingina A and Feld LD contributed to editing, revising, and finalizing the manuscript; Feld LD supervised the project; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Katherine M Cooper, MD, Doctor, Department of Medicine, UMass Chan Medical School, 55 Lave Ave North, Worcester, MA 01655, United States. katherine.cooper@umassmed.edu
Received: November 27, 2023
Revised: February 10, 2024
Accepted: March 27, 2024
Published online: June 18, 2024
Processing time: 200 Days and 6.8 Hours
Abstract

Sarcopenic obesity increases the risk of mortality in patients with liver disease awaiting liver transplantation and in the post-transplant period. Nutrition recommendations for individuals with sarcopenia differ from recommendations for patients with obesity or sarcopenic obesity. While these nutrition guidelines have been established in non-cirrhotic patients, established guidelines for liver transplant candidates with sarcopenic obesity are lacking. In this paper, we review existing literature on sarcopenic obesity in patients with chronic liver disease and address opportunities to improve nutritional counseling in patients awaiting liver transplantation.

Keywords: Nutrition; Sarcopenia; Sarcopenic obesity; Liver transplant; Cirrhosis; Chronic liver disease; Body composition; Myostatin

Core Tip: Sarcopenic obesity is common among patients with chronic liver disease and is associated with increased mortality both pre- and post-liver transplantation. Although nutrition guidelines exist for non-cirrhotic patients with sarcopenic obesity, there is limited data on nutrition recommendations for those with liver disease. Here, we discuss sarcopenic obesity in liver transplant candidates and review nutrition recommendations for this specific population.