Author/Authors :
Bertuzzo ، Valentina Rosa General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna , Renzulli ، Matteo Department of Radiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna , Clemente ، Alfredo Radiology and Radiotherapy Unit, Department of Precision Medicine - University of Campania L. Vanvitelli , Cucchetti ، Alessandro Department of Medical and Surgical Sciences - University of Bologna , Maroni ، Lorenzo General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna , Frascaroli ، Giacomo General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna , Pellegrini ، Sara Department of Medical and Surgical Sciences - University of Bologna , Dajti ، Elton Department of Medical and Surgical Sciences - University of Bologna , Spinelli ، Daniele Department of Radiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna , Peta ، Giuliano Department of Radiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna , Maria Ierardi ، Anna Diagnostic and Interventional Radiology Department - San Paolo Hospital - University of Milan , Carrafiello ، Gianpaolo Diagnostic and Interventional Radiology Department - San Paolo Hospital - University of Milan , Strigari ، Lidia Department of Medical Physics - Policlinico S.Orsola Malpighi , Colecchia ، Antonio Unit of Gastroenterology - Verona University Hospital , Golfieri ، Rita Department of Radiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna , Pinna ، Antonio Daniele General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna , Ravaioli ، Matteo General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna , Cescon ، Matteo General and Transplant Surgery Unit, Department of Organ Failure and Transplant - Sant’Orsola Hospital - University of Bologna
Abstract :
Background: 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.
Keywords :
Sarcopenia , Malnutrition , Liver Transplant , Muscle Density , Complications , Infection , MELD
