The evolution and impact of sarcopenia pre- and post-liver transplantation

被引:70
作者
Bhanji, Rahima A. [1 ]
Takahashi, Naoki [2 ]
Moynagh, Michael R. [2 ]
Narayanan, Praveena [1 ]
Angirekula, Mounika [1 ]
Mara, Kristin C. [3 ]
Dierkhising, Ross A. [3 ]
Watt, Kymberly D. [1 ]
机构
[1] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN USA
[2] Mayo Clin, Dept Radiol, Rochester, MN USA
[3] Mayo Clin, Div Biomed Stat & Informat, Rochester, MN USA
关键词
SEVERE MUSCLE DEPLETION; CIRRHOSIS; MALNUTRITION; SURVIVAL;
D O I
10.1111/apt.15161
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. Aims To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. Methods Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293). Results Sarcopenia was present in 146/293 (50%) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 +/- 4.9 cm(2)/m(2); P < 0.001), and an increase in myosteatosis while awaiting liver transplantation. There was no significant change in abdominal visceral fat. For every 1 cm(2)/m(2) decrease in muscle mass there was an increase in post-transplant length of stay by 0.36 days (P = 0.005). Post-transplant, 98/161 (61%) of patients with CT imaging had sarcopenia (25 de novo and 73 persistent), with continued increase in myosteatosis, lower Hounsfield units (-5.0 [IQR -8.6 to 0.1]; P < 0.001) and an increase in abdominal visceral fat (4.9 [IQR -4.4 to 15.6] cm(2)/m(2); P < 0.001). There was no statistically significant difference in 1-year mortality in patients with de novo sarcopenia compared to patients with sarcopenia both pre- and post-transplant (HR 1.88; P = 0.088). Conclusions Sarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.
引用
收藏
页码:807 / 813
页数:7
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