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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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Changes in sarcopenic status during the peri-transplant period.LT, liver transplantation
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pone.0143966.g002: Changes in sarcopenic status during the peri-transplant period.LT, liver transplantation

Mentions: Preoperative CT scans were performed at a mean of 0.3 ± 0.81 months before LT, and postoperative CT scans at a mean of 12.3 ± 5.7 months after LT. Pre-LT sarcopenia was diagnosed in 52 (36%) patients (Fig 2), with a greater prevalence in males than in females (41% vs. 14%, p = 0.008). In all pre-LT sarcopenic patients, sarcopenia persisted and no change was observed in sarcopenic status after LT. Of the 93 patients who did not have pre-LT sarcopenia, 14 (15%) newly developed sarcopenia after LT. Therefore, the prevalence of post-LT sarcopenia increased to 46% (n = 66) at 1 year after LT.


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)

Changes in sarcopenic status during the peri-transplant period.LT, liver transplantation
© Copyright Policy
Related In: Results  -  Collection

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

pone.0143966.g002: Changes in sarcopenic status during the peri-transplant period.LT, liver transplantation
Mentions: Preoperative CT scans were performed at a mean of 0.3 ± 0.81 months before LT, and postoperative CT scans at a mean of 12.3 ± 5.7 months after LT. Pre-LT sarcopenia was diagnosed in 52 (36%) patients (Fig 2), with a greater prevalence in males than in females (41% vs. 14%, p = 0.008). In all pre-LT sarcopenic patients, sarcopenia persisted and no change was observed in sarcopenic status after LT. Of the 93 patients who did not have pre-LT sarcopenia, 14 (15%) newly developed sarcopenia after LT. Therefore, the prevalence of post-LT sarcopenia increased to 46% (n = 66) at 1 year after LT.

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