Longitudinal CT study of sarcopenia due to hepatic failure after living donor liver transplantation

Background: The quantity and quality of skeletal muscle have been observed to be closely related with post-transplantation mortality in patients undergoing living donor liver transplantation (LDLT). However, the effect of LDLT on skeletal muscle has not been thoroughly investigated. The aim of this study was to investigate the change of trunk muscle mass and adiposity in recipients of LDLT. Methods: The study population included LDLT recipients at Hokkaido University Hospital who underwent pre-and post-operative computed tomography (CT) scans (31 recipients; 14 males, and 17 females). The cross-sectional area of the dorsal muscle group at the 12th thoracic vertebra (Th12) was measured with the dorsal muscle group mass index (DMGMI), while the psoas muscle at the upper border of 4th lumber vertebra (L4) was measured with the psoas muscle mass index (PMI). Muscle adiposity of the dorsal muscle group was also measured with the intramuscular adipose tissue content (IMAC). For these data, the correlation between pre-operative values and follow-up changes (post-operative values minus pre-operative values) were analyzed. Each sex was evaluated separately. Results: A statistically significant correlation was detected between pre-operative values and follow-up differences in DMGMI for both sexes (male: r=-0.675, P= 0.008; female: r=-0.687, P= 0.002) and in PMI for both sexes (males: r=-0.739, P= 0.003; females: r=-0.641, P= 0.006). The correlation of pre-operative values and follow-up differences for IMAC was not statistically significant with r= 0.132 (P= 0.700) and r=-0.498 (P= 0.071) for males and females, respectively. Conclusions: Improvement of sarcopenia in recipients of LDLT can be demonstrated regardless of sex using volumetric CT.