Elsevier

Transplantation Proceedings

Volume 46, Issue 9, November 2014, Pages 3043-3046
Transplantation Proceedings

22nd Congress of the Latin American Transplantation Society
Liver transplantation
Correlation Between Functional Capacity and Respiratory Assessment of End-Stage Liver Disease Patients Waiting for Transplant

https://doi.org/10.1016/j.transproceed.2014.07.014Get rights and content

Abstract

Introduction

End-stage liver disease has metabolic complications associated with malnutrition, which involves a great loss of muscle mass. This complication can lead to changes in the diaphragm, which along with ascites may impair daily activities and result in global motor disability and physical inactivity of patients on the waiting list for liver transplantation.

Objectives

This study sought to delineate the profile of candidates for liver transplantation while on the waiting list at the Clinical Hospital of State University Campinas (UNICAMP), and to assess and verify whether there is a correlation between functional status of the individuals tested using the 6-minute walk test (6MWT), pulmonary function test (PFT), and respiratory muscle strength with end-stage liver disease candidates for liver transplantation.

Methods

This study was carried out in the Liver Transplantation Unit of the State University of Campinas (UNICAMP). We included 46 patients with end-stage liver disease who underwent the following evaluations: medical history, 6MWT, PFT, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP), and SF-36.

Results

Correlations were found between the respiratory variables 6MWT and PFT. The walked distance was correlated with MIP and MEP. There was no correlation between the 6MWT and the variables body mass index and age.

Conclusion

Candidates for liver transplantation have decreased muscle strength, normal lung function, and impaired quality of life, mainly due to physical limitations. Functional status may be correlated with the respiratory assessment (muscle strength and pulmonary function test) in liver disease candidates for transplantation.

Section snippets

Methods

This was a prospective study performed at the Liver Transplantation Unit of UNICAMP. This study was approved by the Research Ethics Committee of UNICAMP under process 922/2009, and the subjects gave a formal consent. We included chronic liver disease patients of both sexes, above 18 years old. We excluded those who were unable to understand verbal commands and those diagnosed with acute liver failure.

After the initial assessment and medical history of 46 subjects, we performed maximal

Results

We evaluated 46 patients with end-stage liver disease; 11 were female and 35 were male. The demographic features and clinical outcomes of the population are described in Table 1. The data mean and standard deviation of the ratings are as follows: PFT (%): FVC, 86.76 ± 15.90; FEV1, 86.04 ± 18.83; FEF25-75, 91.26 ± 38.37; MIP, 92.28 ± 44.57; MIP predicted, 102.8 ± 13.8; MEP, 107.39 ± 41.82; MEP predicted, 109.3 ± 18.2; 6MWT (m), 464 ± 76.85. SF-36: FC, 62.3 ± 26.6; PA, 51 ± 38.2; P, 62 ± 28.8;

Discussion

The changes that commonly affect the quality of life of patients with chronic liver disease, such as malnutrition, sarcopenia, and fatigue, are described in the literature. However, it is necessary to study respiratory changes that may be present in this population, whether in strength or in lung volumes and capacities, in order to develop rehabilitation protocols to prevent pulmonary complications after transplantation.

In our study we observed that patients had a mean BMI of 28.68, which does

References (21)

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Supported by FAPESP number 2010/19326-5, until 2013/07/31.

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