PLoS ONE (Jan 2015)

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

  • Ja Young Jeon,
  • Hee-Jung Wang,
  • So Young Ock,
  • Weiguang Xu,
  • Jung-Dong Lee,
  • Jei Hee Lee,
  • Hae Jin Kim,
  • Dae Jung Kim,
  • Kwan Woo Lee,
  • Seung Jin Han

DOI
https://doi.org/10.1371/journal.pone.0143966
Journal volume & issue
Vol. 10, no. 11
p. e0143966

Abstract

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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.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.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).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.