Retrospective Analysis of the Effect of Sarcopenia on Mortality and Morbidity in Liver Transplant Patients

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-05-08 DOI:10.1016/j.transproceed.2025.03.016

Ahmet Onur Demirel , Uğur Topal , Burak Yavuz , Yunus Kaycı , Cihan Atar , Ahmet Gökhan Sarıtaş , Abdullah Ülkü , Ferhat Can Pişkin , Atılgan Tolga Akçam

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引用次数: 0

Abstract

Background

Sarcopenia significantly influences morbidity and mortality in liver transplant recipients. The psoas muscle area index and prognostic nutritional index (PNI) are potential indicators of sarcopenia’s impact on postoperative outcomes. However, their association with postoperative morbidity and mortality in cadaveric liver transplant recipients remains underexplored.

Methods

Data from 52 patients who underwent cadaveric liver transplantation at Çukurova University over 10 years were analyzed. Sarcopenia was assessed using psoas muscle area index (cutoffs, 4.62 mm²/cm² for males and 2.66 mm²/cm² for females, based on Bahat et al) and PNI (cutoffs, ≤45 for low and >45 for high, based on Li et al). Postoperative morbidity was evaluated using the Clavien–Dindo classification. The main outcomes were overall survival and morbidity rates.

Results

Sarcopenic patients had shorter survival (62.2 ± 16.4 months) compared with nonsarcopenic patients (83.6 ± 11.4 months), although this difference was not statistically significant (P = .370). Sarcopenia was more common in males, Child–Pugh C patients, those with ascites, American Society of Anesthesiologists score of ≥3, and a Clavien–Dindo grade of ≥3 patients. It was significantly associated with low body mass index and albumin levels (P < .05) and was more prevalent in the low PNI group. A significant correlation was observed between PNI and Child–Pugh score (P = .012), alpha fetoprotein, and albumin levels (P = .007 and P = .001).

Conclusion

Sarcopenia negatively impacts survival, whereas a higher PNI correlates with a lower mortality risk. Further multicenter prospective studies with a larger population are needed to validate these findings.

查看原文本刊更多论文

肝移植患者肌肉减少症对死亡率和发病率影响的回顾性分析。

背景：肌肉减少症显著影响肝移植受者的发病率和死亡率。腰肌面积指数和预后营养指数（PNI）是肌肉减少症对术后预后影响的潜在指标。然而，它们与尸体肝移植受者术后发病率和死亡率的关系仍未得到充分探讨。方法：对Çukurova大学10年来52例尸体肝移植患者的资料进行分析。通过腰大肌面积指数（临界值，男性为4.62 mm²/cm²，女性为2.66 mm²/cm²，基于Bahat等人）和PNI（临界值，低≤45，高≤45，基于Li等人）评估肌肉减少症。术后发病率采用Clavien-Dindo分类进行评估。主要结局是总生存率和发病率。结果：肌少症患者的生存期（62.2±16.4个月）短于非肌少症患者（83.6±11.4个月），但差异无统计学意义（P = 0.370）。肌少症在男性、Child-Pugh C患者、腹水患者、美国麻醉医师学会评分≥3分、Clavien-Dindo评分≥3分患者中更为常见。它与低体重指数和白蛋白水平显著相关（P < 0.05），并且在低PNI组中更为普遍。PNI与Child-Pugh评分（P = 0.012）、甲胎蛋白和白蛋白水平（P = 0.007和P = 0.001）有显著相关性。结论：骨骼肌减少症对生存率有负面影响，而较高的PNI与较低的死亡风险相关。需要更多人群的多中心前瞻性研究来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.