Upper thigh skeletal muscle index predicts outcomes in liver transplant recipients
10.4174/astr.2023.105.4.219
- Author:
Manuel LIM
1
;
Jong Man KIM
;
Jaehun YANG
;
Jieun KWON
;
Kyeong Deok KIM
;
Eun Sung JEONG
;
Jinsoo RHU
;
Gyu-Seong CHOI
;
Jae-Won JOH
;
Suk-Koo LEE
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2023;105(4):219-227
- CountryRepublic of Korea
- Language:English
-
Abstract:
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 cm 2 /m 2 for females (area under the curve [AUC], 0.927; P < 0.001) and 46.7 cm 2 /m 2 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.
