title: Risk factors for loss of lean body mass after liver transplantation.
abstract: BACKGROUND
  After liver transplantation there is a fall in lean body mass.
  
  
  OBJECTIVE
  To determine the risk factors for this fall in lean body mass using univariate and subgroup analyses.
  
  
  METHODS
  Dual energy X-ray absorptiometry was performed in 36 patients (12 with Child-Pugh Class A, 20 with Class B and 4 with Class C disease) before and up to 24 months after liver transplantation. Univariate and sub-group comparative analyses were performed to assess possible risk factors for the fall in lean body mass post-transplantation.
  
  
  RESULTS
  The pre-transplantation serum albumin inversely correlated with the fall lean body mass at 1 month (r = 0.55; p < 0.009) and at 6-9 months (r = 0.51; p < 0.05) post-transplantation. A positive correlation between the fall in lean body mass and: (i) cumulative dose of steroids administered at 2-5 months (r = 0.57; p < 0.05) and (ii) length of hospital stay after transplantation (r = 0.52; p < 0.05) were also observed. Neither the severity or presence of cholestatic liver disease pre-transplant, nor acute cellular rejection post-transplant were risk factors for a fall in lean mass.
  
  
  CONCLUSIONS
  A hypercatabolic state post-transplant (represented by low albumin pre-transplantation), immobility, lack of exercise and steroid induced catabolism of muscle may cause the observed fall in lean mass after liver transplantation. Earlier transplantation of patients with better nutritional status and the use of low dose steroid immunosuppressive regimens may prevent the observed fall in lean body mass after transplantation.
authors.affiliation: Department of Medicine, St James' University Hospital, Leeds, U.K.
authors.forename: S H
authors.initials: SH
authors.lastname: Hussaini
authors.forename: S
authors.initials: S
authors.lastname: Soo
authors.forename: S P
authors.initials: SP
authors.lastname: Stewart
authors.forename: B
authors.initials: B
authors.lastname: Oldroyd
authors.forename: F
authors.initials: F
authors.lastname: Roman
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
authors.forename: J G
authors.initials: JG
authors.lastname: O'Grady
authors.forename: M S
authors.initials: MS
authors.lastname: Losowsky
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001823:Body Composition; D001824:Body Constitution; D001835:Body Weight; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index
chemical_list: D012709:Serum Albumin