Muscle mass, hepatocellular carcinoma and liver transplantations: a review

Article: Impact of muscle mass on survival of patients with hepatocellular carcinoma after liver transplantation beyond the Milan criteria

For hepatocellular carcinoma, the most common type of liver cancer, liver transplantations are considered the best treatment, as they present with a 60-80% survival rate for 5 years. Suitability for a transplant is assessed by factors such as the patient’s tumour presentation and their responses to treatments, with the Milan Criteria representing the total criteria with all additional prognostic factors. Yet, general health is rarely included into this judgement. General health, especially low muscle pass (e.g, sarcopenia) may affect survival rates for liver transplantations; this has, however, rarely been addressed. This study discovered that a higher pre-operative muscle mass contributed to an increased rate of long-term survival post-liver transplantation.

This review by Beumer B et al. aimed to determine whether adding in the consideration of muscle mass, and working beyond the Milan Criteria, may benefit our understanding of the outcomes of liver transplantations.

Key learnings Although a higher muscle mass correlated with increased long-term survival rates, low muscle mass cannot be seen as an absolute contra-indication for liver transplantations. This is because this factor’s discriminatory performance was fairly limited. Further research is needed to fully understand the relationship between muscle mass and the survival rates of liver transplantations.

Reviewed by: Z. Beketova

Authors: Beumer B, Van Vugt J, Sapisochin G, et al.

Published in: JCSM 2022