Functional Assessment in Liver Transplantation

Patients will be asked to perform the following study procedures:

1. Assessment for hepatic encephalopathy using the Numbers Connection Test. This test
requires the patient to connect numbers in sequence that are scattered at random on a
piece of paper.

2. Measures of frailty and disability selected to capture the multi-dimensional aspects of
frailty including functional status and physiologic reserve:

Fried Frailty Score: weakness (test of grip strength), exhaustion (patient interview),
slowness (gait speed), low activity (patient interview) Short Physical Performance
Battery: repeated chair stands, balance testing with feet together, 13-foot walk

3. Laboratory tests will all be obtained from the medical record: creatinine, total
bilirubin, INR, sodium, albumin. All of these tests are necessary for listing for liver
transplantation.

4. Blood draw, urine and stool samples will be collected for a sub-group of 1000 patients.

5. Adipose, muscle, liver tissue, and blood will be collected during the liver transplant
surgery for a sub-group of 1000 patients.

Inclusion Criteria:

- Adult (≥18 years old)

- Underlying cirrhosis

- Listed for liver transplantation

- Are seen in the outpatient clinic setting

Exclusion Criteria:

- Have severe hepatic encephalopathy at enrollment (defined by the time to complete the
Numbers Connection Test (NCT) > 120 seconds).