Frailty associated with higher mortality for women awaiting liver transplants

Women awaiting liver transplants in the United States are known to be about one-third more likely than men to become too ill to undergo surgery or die before receiving a liver.

A recent study headed by UC San Francisco and Columbia University highlights the role that frailty plays in this gender gap.

The study followed 1,405 patients with cirrhosis, of whom 41 percent were women, awaiting liver transplantation at nine transplant centers in the United States.

The men, whose ages ranged from 49 to 63, were more likely to have chronic hepatitis C and alcoholic liver disease (27 percent versus 22, and 33 percent versus 19 percent).

The women, whose ages ranged from 50 to 63, were more likely to have non-alcoholic fatty liver disease and autoimmune cholestatic liver disease (23 percent versus 16 percent, and 23 percent versus 9 percent).

The researchers, led by first author Jennifer Lai, MD, MBA, a general and transplant hepatologist at the UCSF Department of Medicine, found that both genders had similar levels of liver disease severity, but fewer women had high blood pressure and coronary artery disease.

Despite this, they were significantly frailer according to testing using the Liver Frailty Index (LFI), which showed weaker gender-adjusted grip, worse balance and that they were slower to stand up from a sitting position.