title: Impact of sarcopenia on survival in patients undergoing living donor liver transplantation.
abstract: Skeletal muscle depletion, referred to as sarcopenia, predicts morbidity and mortality in patients undergoing digestive surgery. However, the impact on liver transplantation is unclear. The present study investigated the impact of sarcopenia on patients undergoing living donor liver transplantation (LDLT). Sarcopenia was assessed by a body composition analyzer in 124 adult patients undergoing LDLT between February 2008 and April 2012. The correlation of sarcopenia with other patient factors and the impact of sarcopenia on survival after LDLT were analyzed. The median ratio of preoperative skeletal muscle mass was 92% (range, 67-130%) of the standard mass. Preoperative skeletal muscle mass was significantly correlated with the branched-chain amino acids to tyrosine ratio (r = -0.254, p = 0.005) and body cell mass (r = 0.636, p < 0.001). The overall survival rate in patients with low skeletal muscle mass was significantly lower than in patients with normal/high skeletal muscle mass (p < 0.001). Perioperative nutritional therapy significantly increased overall survival in patients with low skeletal muscle mass (p = 0.009). Multivariate analysis showed that low skeletal muscle mass was an independent risk factor for death after transplantation. In conclusion, sarcopenia was closely involved with posttransplant mortality in patients undergoing LDLT. Perioperative nutritional therapy significantly improved overall survival in patients with sarcopenia.
authors.affiliation: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. kaido@kuhp.kyoto-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Kaido
authors.forename: K
authors.initials: K
authors.lastname: Ogawa
authors.forename: Y
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Ogura
authors.forename: K
authors.initials: K
authors.lastname: Hata
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: K
authors.initials: K
authors.lastname: Tomiyama
authors.forename: S
authors.initials: S
authors.lastname: Yagi
authors.forename: A
authors.initials: A
authors.lastname: Mori
authors.forename: S
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017093:Liver Failure / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055948:Sarcopenia / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D015996:Survival Rate / Q000639:trends