Association between skeletal muscle index prior to liver transplantation and 1-year mortality posttransplant

Daphne Bot*, Suzanne Klerks, Eva Leistra, Maarten E. Tushuizen, Bart van Hoek

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Liver transplantation is the only curative therapy for end-stage liver disease (ESLD). Sarcopenia is often defined as the loss of muscle quantity (skeletal muscle index [SMI]), but muscle attenuation (MA), a surrogate marker of muscle quality, is also decreased in ESLD. We assessed pre–liver transplant SMI and MA and their association with posttransplant mortality, complications, and length of intensive care unit (ICU) and hospital stay. Methods: In 169 consecutive patients with ESLD who underwent a liver transplantation between 2007 and 2014, SMI and MA were measured on computed tomography scans at time of placement on the waiting list for liver transplantation. The primary outcome of interest was 1-year posttransplant mortality. Secondary posttransplantation outcomes of interest were complications within 30 days and length of stay in the ICU > 3 days and in the hospital >3 weeks. Logistic and Cox regression analyses were performed. Results: MA was associated with 1-year posttransplant mortality rate (hazard ratio=0.656, 95% CI=0.464–0.921, P = 0.015). The highest quartile of SMI had a lower odds for the total length of stay in the hospital lasting >3 weeks (odds ratio=0.211, 95% CI=0.061–0.733, P = 0.014). MA was associated with a prolonged ICU stay; this was, however, not statistically significant after adjustment for age, sex, and Model for ESLD score. Conclusion: Lower MA is associated with a longer length of ICU stay and 1-year mortality after liver transplantation, whereas low SMI was associated with a total length of hospital stay.

Original languageEnglish
Pages (from-to)867-877
Number of pages11
JournalJournal of Parenteral and Enteral Nutrition
Volume47
Issue number7
Early online date18 Apr 2023
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
The authors would like to thank the Department of Radiology, especially Shirin Shahbazi Feshtali, MD, PhD, for making the CT scans available for this study. We would like to thank Mar Rodriguez-Girondo, PhD, statistician, for her help in the statistical analysis. The authors would like to thank Anneke Droop, RDN, Claudia Lucassen, RDN, Mariëlle van Veen, RDN, and Jeroen van Vugt, MD, PhD for their help in collecting the data for this study. This research did not receive specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Publisher Copyright:
© 2023 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.

Funding

The authors would like to thank the Department of Radiology, especially Shirin Shahbazi Feshtali, MD, PhD, for making the CT scans available for this study. We would like to thank Mar Rodriguez-Girondo, PhD, statistician, for her help in the statistical analysis. The authors would like to thank Anneke Droop, RDN, Claudia Lucassen, RDN, Mariëlle van Veen, RDN, and Jeroen van Vugt, MD, PhD for their help in collecting the data for this study. This research did not receive specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Keywords

  • computed tomography
  • end-stage liver disease
  • liver cirrhosis
  • liver transplantation
  • muscle mass
  • myosteatosis
  • sarcopenia

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