Sarcopenia and frailty: An in-depth analysis of the pathophysiology and effect on liver transplant candidates

Abstract

Cirrhosis represents the end stage of chronic liver disease, significantly reducing life expectancy as it progresses from a compensated to a decompensated state, leading to serious complications. Recent improvements in medical treatment have created a shift in cirrhosis management. Various causes, including hepatitis viruses, alcohol consumption, and fatty liver disease, contribute to cirrhosis and are closely linked to liver cancer. The disease develops through hepatocyte necrosis and regeneration, resulting in fibrosis and sinusoidal capillarization, leading to portal hypertension and complications such as ascites, hepatic encephalopathy, and organ dysfunction. Cirrhosis also holds an increased risk of hepatocellular carcinoma. Diagnosing cirrhosis involves assessing fibrosis scores through blood tests and measuring liver stiffness through elastography. Liver transplantation is the definitive treatment for end-stage liver disease and acute liver failure.

Keywords: Artificial intelligence; Chronic liver disease; Cirrhosis; End-stage liver disease; Frailty; Liver fibrosis; Liver transplant; Muscle mass loss; Pathophysiology; Sarcopenia.