BACKGROUND: The effect of body composition disturbances has been recently in focus. Sarcopenic obesity, a co-occurrence of low muscle mass and high body fat was reportedly predictive of high mortality in patients with cirrhosis. However, the impact of the interacting sarcopenia and overweight on the outcomes after liver transplantation is still unclear. METHODS: We evaluated 200 patients undergoing adult-to-adult living donor liver transplantation at our institution between January 2008 and November 2013 classified according to BMI and psoas muscle index (PMI) on admission to transplant into 4 subgroups; sarcopenic overweight (SO), sarcopenic non-overweight (SN), non-sarcopenic overweight and non-sarcopenic non-overweight (NN). Short-term outcomes and overall post-transplant survival were compared among the four subgroups. RESULTS: Sarcopenic patients with preoperative low PMI had higher incidence of postoperative bacteremia and major postoperative complications, and poorer overall post-transplant survival than non-sarcopenic patients with normal/high PMI (P<0.001, respectively). Overweight recipients had a significantly higher overall survival (OS) rate than non-overweight patients (P=0.021). SO subgroup (low PMI and BMI ≥25) had statistically indifferent incidence of postoperative bacteremia, major postoperative complications or overall post-transplant survival than other recipients. In contrast, SN subgroup (low PMI and BMI <25) had higher incidence of postoperative bacteremia (P<0.001), major postoperative complications (P<0.001) than the SO subgroup and possessed the poorest OS among the four recipient subgroups (P=0.001). CONCLUSIONS: In living donor liver transplantation, preoperative SO did not confer added significant morbidity or mortality risks than the stand-alone sarcopenia.
BACKGROUND: The effect of body composition disturbances has been recently in focus. Sarcopenic obesity, a co-occurrence of low muscle mass and high body fat was reportedly predictive of high mortality in patients with cirrhosis. However, the impact of the interacting sarcopenia and overweight on the outcomes after liver transplantation is still unclear. METHODS: We evaluated 200 patients undergoing adult-to-adult living donor liver transplantation at our institution between January 2008 and November 2013 classified according to BMI and psoas muscle index (PMI) on admission to transplant into 4 subgroups; sarcopenic overweight (SO), sarcopenic non-overweight (SN), non-sarcopenic overweight and non-sarcopenic non-overweight (NN). Short-term outcomes and overall post-transplant survival were compared among the four subgroups. RESULTS: Sarcopenic patients with preoperative low PMI had higher incidence of postoperative bacteremia and major postoperative complications, and poorer overall post-transplant survival than non-sarcopenic patients with normal/high PMI (P<0.001, respectively). Overweight recipients had a significantly higher overall survival (OS) rate than non-overweight patients (P=0.021). SO subgroup (low PMI and BMI ≥25) had statistically indifferent incidence of postoperative bacteremia, major postoperative complications or overall post-transplant survival than other recipients. In contrast, SN subgroup (low PMI and BMI <25) had higher incidence of postoperative bacteremia (P<0.001), major postoperative complications (P<0.001) than the SO subgroup and possessed the poorest OS among the four recipient subgroups (P=0.001). CONCLUSIONS: In living donor liver transplantation, preoperative SO did not confer added significant morbidity or mortality risks than the stand-alone sarcopenia.
Entities:
Keywords:
Living donor liver transplantation (LDLT); overweight; psoas muscle index (PMI); sarcopenia
Authors: Anna J Dare; Lindsay D Plank; Anthony R J Phillips; Edward J Gane; Barry Harrison; David Orr; Yannan Jiang; Adam S J R Bartlett Journal: Liver Transpl Date: 2014-03 Impact factor: 5.799
Authors: Trevor W Reichman; George Therapondos; Maria-Stella Serrano; John Seal; Rachel Evers-Meltzer; Humberto Bohorquez; Ari Cohen; Ian Carmody; Emily Ahmed; David Bruce; George E Loss Journal: World J Hepatol Date: 2015-06-18
Authors: Kostan W Reisinger; Joep P M Derikx; Jeroen L A van Vugt; Maarten F Von Meyenfeldt; Karel W Hulsewé; Steven W M Olde Damink; Jan H M B Stoot; Martijn Poeze Journal: Clin Nutr Date: 2015-07-16 Impact factor: 7.324
Authors: Soo Lim; Jung Hee Kim; Ji Won Yoon; Seon Mee Kang; Sung Hee Choi; Young Joo Park; Ki Woong Kim; Jae Young Lim; Kyong Soo Park; Hak Chul Jang Journal: Diabetes Care Date: 2010-05-11 Impact factor: 19.112
Authors: J L A van Vugt; S Levolger; R W F de Bruin; J van Rosmalen; H J Metselaar; J N M IJzermans Journal: Am J Transplant Date: 2016-04-04 Impact factor: 8.086
Authors: A Ari Hakimi; Helena Furberg; Emily C Zabor; Anders Jacobsen; Nikolaus Schultz; Giovanni Ciriello; Nina Mikklineni; Brandon Fiegoli; Philip H Kim; Martin H Voss; Hui Shen; Peter W Laird; Chris Sander; Victor E Reuter; Robert J Motzer; James J Hsieh; Paul Russo Journal: J Natl Cancer Inst Date: 2013-11-27 Impact factor: 13.506
Authors: Nghiem B Ha; Aldo J Montano-Loza; Elizabeth J Carey; Shezhang Lin; Amy M Shui; Chiung-Yu Huang; Michael A Dunn; Jennifer C Lai Journal: Am J Transplant Date: 2022-05-13 Impact factor: 9.369