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Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

Jeon JY, Wang HJ, Ock SY, Xu W, Lee JD, Lee JH, Kim HJ, Kim DJ, Lee KW, Han SJ - PLoS ONE (2015)

Bottom Line: The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others.Newly developed sarcopenia was associated with increased mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.

ABSTRACT

Introduction: The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.

Method: This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.

Results: The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024).

Conclusion: Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

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Study population framework.LT, liver transplantation, CT, computed tomography
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pone.0143966.g001: Study population framework.LT, liver transplantation, CT, computed tomography

Mentions: This study was a retrospective study based on a cohort of patients who underwent LT at Ajou University Hospital (Suwon, Republic of Korea). The characteristics of these patients were reported previously [18–20]. Between February 2005 and February 2014, 308 patients underwent LT. The present study included 145 adult LT patients who had undergone abdominal CT scans just before and 1 year after LT (Fig 1). Pediatric patients (n = 2), patients with re-transplantation (n = 9) or dual transplantation (n = 6), patients whose follow-up duration after LT was less than 6 months (n = 11), patients who died within 6 months after LT (n = 43), and patients (n = 92) who had no abdominal CT scans 1 year after LT were excluded from the study. Only LT recipients who also underwent a postoperative CT scan at a mean of 1 year after LT were included, such that our results may not be applicable to all LT recipients. However, the clinical characteristics of the excluded patients who did not have postoperative CT scans, such as age (49.2 ± 9.0 years), BMI (24.0 ± 4.0 kg/m2), sex (71.7% males), and donor age (35.1 ± 14.5 years) were not significantly different from those of the final study population. Postoperative mortality as an outcome of the non-study patients group without a postoperative CT was not significantly different compared to the study patients group (adjusted HR, 0.90; 95% confidence interval, 0.37–2.15; p = 0.803). None of the patients underwent any pretransplant sarcopenic intervention, such as nutrition, physical therapy or a modification of their medications.


Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

Jeon JY, Wang HJ, Ock SY, Xu W, Lee JD, Lee JH, Kim HJ, Kim DJ, Lee KW, Han SJ - PLoS ONE (2015)

Study population framework.LT, liver transplantation, CT, computed tomography
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664264&req=5

pone.0143966.g001: Study population framework.LT, liver transplantation, CT, computed tomography
Mentions: This study was a retrospective study based on a cohort of patients who underwent LT at Ajou University Hospital (Suwon, Republic of Korea). The characteristics of these patients were reported previously [18–20]. Between February 2005 and February 2014, 308 patients underwent LT. The present study included 145 adult LT patients who had undergone abdominal CT scans just before and 1 year after LT (Fig 1). Pediatric patients (n = 2), patients with re-transplantation (n = 9) or dual transplantation (n = 6), patients whose follow-up duration after LT was less than 6 months (n = 11), patients who died within 6 months after LT (n = 43), and patients (n = 92) who had no abdominal CT scans 1 year after LT were excluded from the study. Only LT recipients who also underwent a postoperative CT scan at a mean of 1 year after LT were included, such that our results may not be applicable to all LT recipients. However, the clinical characteristics of the excluded patients who did not have postoperative CT scans, such as age (49.2 ± 9.0 years), BMI (24.0 ± 4.0 kg/m2), sex (71.7% males), and donor age (35.1 ± 14.5 years) were not significantly different from those of the final study population. Postoperative mortality as an outcome of the non-study patients group without a postoperative CT was not significantly different compared to the study patients group (adjusted HR, 0.90; 95% confidence interval, 0.37–2.15; p = 0.803). None of the patients underwent any pretransplant sarcopenic intervention, such as nutrition, physical therapy or a modification of their medications.

Bottom Line: The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others.Newly developed sarcopenia was associated with increased mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.

ABSTRACT

Introduction: The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.

Method: This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.

Results: The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024).

Conclusion: Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

Show MeSH
Related in: MedlinePlus