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KMID : 0371420231050040219
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Annals of Surgical Treatment and Research
2023 Volume.105 No. 4 p.219 ~ p.227
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Upper thigh skeletal muscle index predicts outcomes in liver transplant recipients
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Lim Man-Uel
Kim Jong-Man
Yang Jae-Hun
Kwon Ji-Eun
Kim Kyeong-Deok
Jeong Eun-Sung
Rhu Jin-Soo
Choi Gyu-Seong
Joh Jae-Won
Lee Suk-Koo
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Abstract
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Purpose : The skeletal muscle index (SMI) at the L3 level is widely used to diagnose sarcopenia. The upper thigh (UT) also reflects changes in whole-body muscle mass, but no study has examined this using the UT to diagnose sarcopenia in liver transplantation (LT). This study aimed to determine an optimal cut-off value for UT-SMI and investigate how sarcopenia diagnosed by UT-SMI correlates with outcomes in LT recipients.
Methods : In this retrospective study of 332 LT patients from 2018 to 2020, we investigated the association between sarcopenia diagnosed by UT-SMI and patient outcomes after LT.
Results : The cut-off values for UT-SMI were 38.3 cm2/m2 for females (area under the curve [AUC], 0.927; P < 0.001) and 46.7 cm2/m2 for males (AUC, 0.898; P < 0.001). The prevalence of sarcopenia diagnosed by UT-SMI was 33.4% in our cohort. Patient and graft survival rates in the UT-SMI sarcopenia group were significantly poorer than those in the UT-SMI non-sarcopenia group (P < 0.001 and P < 0.001). UT-SMI was an independent prognostic factor for patient survival (hazard ratio [HR], 2.182; 95% confidence interval [CI], 1.183?4.025; P = 0.012) and graft survival (HR, 2.227; 95% CI, 1.054?4704; P = 0.036) in our multivariable Cox analysis.
Conclusion : We confirmed that sarcopenia diagnosed by UT-SMI is associated with outcomes in LT recipients. In addition, UT-SMI was identified as an independent prognostic factor for patient survival and graft survival. Therefore, UT-SMI could be a good option for CT-based evaluations of sarcopenia in LT recipients.
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KEYWORD
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Liver transplantation, Sarcopenia, Skeletal muscle, Thigh
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