AB055. SOH21AS155. Clinical correlation of frailty measures and evaluation of complementary molecular frailty biomarker candidates in a prospective national cohort of liver transplant candidates
Plenary Session

AB055. SOH21AS155. Clinical correlation of frailty measures and evaluation of complementary molecular frailty biomarker candidates in a prospective national cohort of liver transplant candidates

Sinead Cremen1,2, Mark Robinson3, Diarmaid Houlihan4, Tom Gallagher1

1Department of Hepatobiliary and Liver Transplant Surgery, St. Vincent’s University Hospital, Dublin, Ireland; 2School of Medicine, University College Dublin, Dublin, Ireland; 3Department of Biology, Maynooth University, Kildare, Ireland; 4Department of Hepatology, St. Vincent’s University Hospital, Dublin, Ireland

Background: Frailty is a clinical condition characterised by loss of physiologic reserve and increased susceptibility to stressors. The prevalence of frailty is increased in cirrhotic patients. Molecular frailty biomarkers may reflect the dysregulation of physiological systems leading to this reduced physiological reserve, but as yet such complementary biomarkers have not been identified.

Methods: Seventy patients were prospectively evaluated while undergoing liver transplant assessment. Clinical assessments included Liver Frailty Index (LFI), Fried Frailty Index (FFI), and Rockwood Frailty Score (RFS). Serum irisin, S100B, leptin and PAI-1 concentrations were assayed (ELISA) in a subset of patients. Assessments were repeated at 3-monthly intervals whilst wait-listed and post-transplant. Outcomes included decompensation-related hospitalisations, time on the waiting-list and post-transplant outcomes.

Results: Clinical frailty ranged from 20% to 37%, depending on the frailty score. Increasing FFI and RFS scores were associated with increased S100B (P=0.02). There was also a positive correlation between higher MELD-Na (Model for End-Stage Liver Disease) and PAI-1 (P=0.014) and negative correlation between MELD-Na and Leptin (P=0.059). Increasing MELD-Na, RFS and female sex were associated with an increased likelihood of admission with liver decompensation while on the waiting list. Although Frailty increased on the waitlist, the frailest patients spent a significantly shorter period on the list (P=0.026).

Conclusions: This study adds objectivity to what was previously a nuanced aspect of patient selection. We have demonstrated the association of clinical frailty scores with novel molecular biomarkers of frailty for the first time. This has significant diagnostic and prognostic implications going forward and warrants validation in larger cohorts.

Keywords: Frailty; liver transplant; outcomes; ELISA

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab055
Cite this abstract as: Cremen S, Robinson M, Houlihan D, Gallagher T. SOH21AS155. Clinical correlation of frailty measures and evaluation of complementary molecular frailty biomarker candidates in a prospective national cohort of liver transplant candidates. Mesentery Peritoneum 2021;5:AB055.

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