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• W4386408029 abstract "We read the letter from Qatomah et al.1 in response to our article on developing the SarcoModel with great interest.2 The letter focused on the impact of the Child-Turcotte-Pugh Score (CPS) and albumin as relevant prognostic indicators for patients with liver cirrhosis. We fully agree with the Authors. As correctly reported by Qatomah et al., CPS presented in our study a robust performance for the risk of dropout in cirrhotic patients with MELDNa < 20. We also agree that such a result was connected with the relevant role of albumin as a surrogate of the overall nutritional status in cirrhotic patients. When we developed our SarcoModel, we initially created a model based on five variables, in which the albumin was a relevant protective factor for the risk of dropout according to the equation: (0.067 × MELDNa) + (0.027 × age years) − (0.113 × total psoas area cm2/m2) − (0.038 × height cm) − (0.440 × albumin g/dL).2 Only with the intent to develop a user-friendly score, we decided to “simplify” the model only using two variables, namely MELDNa and total psoas area. As correctly reported by Qatomah et al., the Sarco-Model incorporating the objective measurement of total psoas area gives relevant information on the nutritional status of cirrhotic patients waiting for liver transplantation (LT). However, this measurement requires specialized computer software that may not be available in every centre. Given such consideration, we agree that albumin should play an excellent role as an alternative surrogate of nutritional status. In a recent study investigating the development of early complications (within 90 days) after LT, we observed that the Controlling Nutritional Status (CONUT) score, based on lymphocyte count, serum albumin, and cholesterol levels, was a helpful tool for identifying patients at increased post-LT morbidity risk.3 The role of the CONUT should also be observed in specific populations like patients with hepatocellular carcinoma.4 A large Italian study reported an unfair prognostic ability of the MELD score, suggesting albumin as a candidate variable for its update.5 In conclusion, the linear correlation between albumin, CONUT, and muscle measurements should be explored to demonstrate the surrogate effect for the nutritional status of an “easy-to-dose” marker. This finding should consent to push in further developing models incorporating albumin as a predictor of pre- and post-LT unfair results. In this light, significant international efforts are needed. Quirino Lai was responsible for the conception, design, analysis, and writing of the study; Ilaria Lenci, Valerio Giannelli, and Giuseppe Marrone were involved with the collection and interpretation of data; Quirino Lai, Ilaria Lenci, Valerio Giannelli, and Giuseppe Marrone participated in data management, review and editing of the manuscript. None about the here presented work. The authors have no conflicts of interest to declare about the present study. Data sharing is not applicable to this article as no datasets were generated or analysed during the current study." @default.
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• W4386408029 date "2023-09-04" @default.
• W4386408029 modified "2023-10-03" @default.
• W4386408029 title "Response to: Letter to the Editor “<scp>Child‐Turcotte‐Pugh</scp> score as a model for organ allocation in liver transplantation, perhaps old is still gold”" @default.
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• W4386408029 doi "https://doi.org/10.1111/liv.15721" @default.
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