Current management strategies for sarcopenia and frailty in cirrhosis: Missing link in transplant candidacy

Figure 3 Conceptual interplay between frailty, sarcopenia, and their shared determinants. Frailty and sarcopenia in cirrhosis converge around impaired muscle health, leading to overlap in their underlying drivers. External contributors, including nutritional deficiency, aging, inactivity, comorbid illnesses, endocrine disruption, hepatic encephalopathy, recurrent hospitalization, and socioeconomic or environmental factors, can individually predispose patients to frailty, sarcopenia, or both (arrows pointing inward). Moreover, these determinants may reinforce each other through bidirectional interactions (arrows within the outer ring), thereby amplifying their impact on muscle decline and clinical outcomes.