1. Sarcopenia adversely impacts postoperative complications in living-donor liver transplantation recipients.
- Author
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Wu MY, Lim WX, Cheng YF, Chang CD, Hsu HW, Lin CC, Chen CL, Chang WC, Yu CY, Tsang LL, Chuang YH, and Ou HY
- Subjects
- Adult, End Stage Liver Disease complications, End Stage Liver Disease diagnosis, End Stage Liver Disease mortality, Female, Humans, Living Donors, Male, Middle Aged, Postoperative Complications etiology, Retrospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Sarcopenia etiology, Severity of Illness Index, Sex Factors, Survival Rate, Transplant Recipients statistics & numerical data, End Stage Liver Disease surgery, Liver Transplantation adverse effects, Postoperative Complications epidemiology, Sarcopenia epidemiology
- Abstract
Despite technological and immunological innovations, living-donor liver transplant (LDLT) recipients still face substantial risk of postoperative complications. Sarcopenia is being recognized more and more as a biomarker that correlates with poor outcomes in surgical patients. The purpose of this study was to evaluate the relationship between sarcopenia and significant surgical complications in LDLT recipients. This retrospective review included patients who had received LDLT at our institute from 2005 to 2017. Sarcopenia was assessed using the psoas muscle index (PMI) in cross-sectional images. ROC curve analysis was used to determine the ability of PMI to predict postoperative complications. Correlations between major postoperative complications and sarcopenia were evaluated using regression analysis. A total of 271 LDLT recipients were included. No significant differences were found between PMI and major postoperative complications in male patients. Female recipients with major postoperative complications had significantly lower mean PMI values (P = 0.028), and the PMI cut-off value was 2.63 cm
2 /m2 . Postoperative massive pleural effusion requiring pigtail drainage occurred more frequently in the sarcopenia group than in the non-sarcopenia group (P = 0.003). 1-, 3-, 5- and 10-year overall survival rates in female were significantly poorer in the sarcopenia group (n = 14) compared with the non-sarcopenia group (n = 108), at 92.9% versus 97.2%, 85.7% versus 95.4%, 85.7% versus 92.5% and 70.1 versus 82.0%, respectively (P = 0.041) and 94.6%, 89.9%, 85.9% and 78.5% in male patients. Sarcopenia is associated with a significantly higher risk of major postoperative complications in females. PMI and sarcopenia together are predictive of major postoperative complications and survival rates in female LDLT recipients., (© 2021. The Author(s).)- Published
- 2021
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