Pre-transplant Psoas Muscle Density as a Ready-to-Use and Low-cost Predictor of Patient Survival After Liver Transplant

AuthorValentina Rosa Bertuzzoen
AuthorMatteo Renzullien
AuthorAlfredo Clementeen
AuthorAlessandro Cucchettien
AuthorLorenzo Maronien
AuthorGiacomo Frascarolien
AuthorSara Pellegrinien
AuthorElton Dajtien
AuthorDaniele Spinellien
AuthorGiuliano Petaen
AuthorAnna Maria Ierardien
AuthorGianpaolo Carrafielloen
AuthorLidia Strigarien
AuthorAntonio Colecchiaen
AuthorRita Golfierien
AuthorAntonio Daniele Pinnaen
AuthorMatteo Ravaiolien
AuthorMatteo Cesconen
OrcidGiuliano Peta [0000-0002-7313-4136]en
Issued Date2021-04-30en
AbstractBackground: Sarcopenia, defined as low muscle mass with reduced function, is frequently encountered in cirrhotic patients and is a major predictor of adverse events, including post-liver transplant (LT) outcome. Objectives: This study assessed the impact of sarcopenia using computed tomography (CT)-based measurements on post-LT mortality and complications. Methods: From January 2008 to June 2016, 646 adult patients underwent 613 LTs at our institution. We analyzed the postoperative outcome of 287 patients who had pathologically proven cirrhosis on the explanted liver and who had performed a CT examination three months before LT. Psoas muscle density (PMD) was detected for every patient using standard instruments present in the radiological workstation and was related to postoperative survival rates and complications. Statistical analysis was carried out using the appropriate tests. Results: Postoperative mortality was 6.3%. At least one grade III-IV postoperative complication was experienced by 121 patients. Respiratory and infective complications occurred in 30 and 32 patients, respectively. Also, PMD was an independent predictor of postoperative mortality (P = 0.021), respiratory complications (P = 0.015), and infections (P = 0.010). The ROC analysis identified a PMD ≤ 43.72 HU as the best cutoff value for predicting 90-day mortality after LT. Conclusions: Psoas muscle density accurately predicted post-LT mortality and complications. Its ease and low-cost determination can allow widespread use of this parameter to improve clinical care and help with the decision to give these patients some priority on the transplant waiting list.en
DOIhttps://doi.org/10.5812/hepatmon.99690en
KeywordSarcopeniaen
KeywordMalnutritionen
KeywordLiver Transplanten
KeywordMuscle Densityen
KeywordComplicationsen
KeywordInfectionen
KeywordMELDen
PublisherBrieflandsen
TitlePre-transplant Psoas Muscle Density as a Ready-to-Use and Low-cost Predictor of Patient Survival After Liver Transplanten
TypeResearch Articleen

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