title: Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.
abstract: BACKGROUND
  The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.
  
  
  METHODS
  This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.
  
  
  RESULTS
  The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024).
  
  
  CONCLUSIONS
  Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Jeon
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Hee-Jung
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Ock
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Weiguang
authors.initials: W
authors.lastname: Xu
authors.affiliation: Office of Biostatistics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Jung-Dong
authors.initials: JD
authors.lastname: Lee
authors.affiliation: Department of Diagnostic Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Jei Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Dae Jung
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Kwan Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Han
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D012044:Regression Analysis; D012189:Retrospective Studies; D055948:Sarcopenia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016019:Survival Analysis