Pre-operative volume rather than area of skeletal muscle is a better predictor for post-operative risks for respiratory complications in living-donor liver transplantation.
OBJECTIVE
To demonstrate the superiority of total psoas volume (TPV) over total psoas area (TPA) in terms of predicting post-operative complications in living-donor liver transplantation (LDLT).


METHODS
The TPA and TPV were assessed in 32 recipients who underwent CT before LDLT. The TPA was measured using an axial CT image at the level of the upper margin of the fourth lumbar vertebral body. The TPV was calculated using all the CT images from the muscle origin through the level of the pubic symphysis. Patients were divided into a sarcopenia group and no-sarcopenia group based on the medians of normalized TPA (nTPA) and normalized TPV (nTPV). We calculated the odds ratio (OR) of post-operative respiratory complications in relation to nTPA and nTPV, respectively.


RESULTS
Out of 32 recipients, 17 recipients experienced at least 1 post-operative respiratory complication. The OR for males according to nTPV [OR = 15.00, 95% confidence interval (CI) = 1.03-218.31; p = 0.031] was higher than that for nTPA (OR = 3.33, 95% CI = 0.36-30.70; p = 0.280). The OR for females according to nTPV (OR = 4.00, 95% CI = 0.56-28.40; p = 0.16) was the same as that for nTPA (OR = 4.00, 95% CI = 0.56-28.40; p = 0.16).


CONCLUSIONS
Pre-operative volume of the skeletal muscle might be a better predictor for post-operative risks in LDLT recipients than pre-operative area of the skeletal muscle. Advances in knowledge: Post-operative risks for respiratory complications in LDLT recipients might be evaluated more accurately by using TPV instead of TPA.
1 Department of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Yuki
Y
Wada
2 Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Tamotsu
T
Kamishima
3 Division of Organ Transplantation, Hokkaido University Hospital, Sapporo, Japan.
Tsuyoshi
T
Shimamura
4 Gastroenterological Surgery 1, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Norio
N
Kawamura
5 Department of Transplant Surgery, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan.
Kenichiro
K
Yamashita
6 Department of Medical Physics, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Kenneth
K
Sutherland
7 Laboratory of Pathophysiology and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Hiroshi
H
Takeda
D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D016658:Psoas Muscles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed