<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of radiologically assessed skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes.</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>Data of 138 adult patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in computer tomography (CT) scan at the third lumbar vertebra level were calculated. Results were analyzed for the length of hospitalisation and postoperative outcomes.</p>
</sec>
<sec><h3>Results</h3>
<p>In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer intensive care unit (ICU) stay (P &lt; 0.025). Low SMI had no influence on ICU stay in female patients (P = 0.544), length of hospitalisation (male, P > 0.05; female, P = 0.843), postoperative complication rates (males, P = 0.883; females, P = 0.113), infection rate (males, P = 0.293, females, P = 0.285) and graft rejection (males, P = 0.875; females, P = 0.135). The presence of MI did not influence ICU stay (P = 0.161), hospitalization (P = 0.771), postoperative complication rates (P = 0.467), infection rate (P = 0.173) or graft rejection rate (P = 0.173).</p>
</sec>
<sec><h3>Conclusions</h3>
<p>In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation. CT body composition analysis of recipients and uniformly accepted cut-off points are crucial to producing reliable data in the future.</p>
</sec>
</abstract>

Background
Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of radiologically assessed skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes.

Patients and methods
Data of 138 adult patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in computer tomography (CT) scan at the third lumbar vertebra level were calculated. Results were analyzed for the length of hospitalisation and postoperative outcomes.

Results
In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer intensive care unit (ICU) stay (P < 0.025). Low SMI had no influence on ICU stay in female patients (P = 0.544), length of hospitalisation (male, P > 0.05; female, P = 0.843), postoperative complication rates (males, P = 0.883; females, P = 0.113), infection rate (males, P = 0.293, females, P = 0.285) and graft rejection (males, P = 0.875; females, P = 0.135). The presence of MI did not influence ICU stay (P = 0.161), hospitalization (P = 0.771), postoperative complication rates (P = 0.467), infection rate (P = 0.173) or graft rejection rate (P = 0.173).

Conclusions
In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation. CT body composition analysis of recipients and uniformly accepted cut-off points are crucial to producing reliable data in the future.

Radiological assessment of skeletal muscle index and myosteatosis and their impact postoperative outcomes after liver transplantation

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of radiologically assessed skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes.

Patients and methods
Data of 138 adult patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in computer tomography (CT) scan at the third lumbar vertebra level were calculated. Results were analyzed for the length of hospitalisation and postoperative outcomes.

Results
In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer intensive care unit (ICU) stay (P  0.05; female, P = 0.843), postoperative complication rates (males, P = 0.883; females, P = 0.113), infection rate (males, P = 0.293, females, P = 0.285) and graft rejection (males, P = 0.875; females, P = 0.135). The presence of MI did not influence ICU stay (P = 0.161), hospitalization (P = 0.771), postoperative complication rates (P = 0.467), infection rate (P = 0.173) or graft rejection rate (P = 0.173).

Conclusions
In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation. CT body composition analysis of recipients and uniformly accepted cut-off points are crucial to producing reliable data in the future.

Background
Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on...

Variable	Min	Max	IQR	SD	95% CI

					Lower	Upper
BMI	15	38	6	4.775	25.13	26.74
Waiting time for liver transplantation (days)	1	691	166	151.311	108.44	159.38
Sodium	121	147	6	4.701	136.09	137.68
Creatinine	41	696	46	67.082	85.91	108.49
Albumin	10	62	10	7.674	31.28	33.86
Protein	23	89	12	11.494	65.80	69.74
Bilirubin	2	687	56	107.535	51.83	88.04
INR	1	4	1	.502	1.44	1.61
MELD score	7	46	9	6.700	14.30	16.56
ALBI score	−4	0	1.13	0.802	−1.87	−1.60

Variable		Myosteatosis

		no	yes
Liver failure	Alcohol-related	32	28
	Virus-related	14	3
	Other	47	14
χ²	9.717
Degrees of freedom (Df)	2
p	0.008

Radiological assessment of skeletal muscle index and myosteatosis and their impact postoperative outcomes after liver transplantation

Article Category: Research Article

Online veröffentlicht: 21. Juni 2023

Seitenbereich: 168 - 177

Eingereicht: 12. März 2023

Akzeptiert: 16. Mai 2023

DOI: https://doi.org/10.2478/raon-2023-0025

Schlüsselwörter
muscle mass, liver transplantation, myosteatosis, skeletal muscle index, GLIM score

© 2023 Miha Petric et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

FIGURE 2.

Laboratory and clinical data of patients

Aetiology of liver disease and incidence of myosteatosis

Radiological assessment of skeletal muscle index and myosteatosis and their impact postoperative outcomes after liver transplantation

Article Category: Research Article

Online veröffentlicht: 21. Juni 2023

Seitenbereich: 168 - 177

Eingereicht: 12. März 2023

Akzeptiert: 16. Mai 2023

DOI: https://doi.org/10.2478/raon-2023-0025

Schlüsselwörtermuscle mass, liver transplantation, myosteatosis, skeletal muscle index, GLIM score

© 2023 Miha Petric et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

FIGURE 2.

Laboratory and clinical data of patients

Aetiology of liver disease and incidence of myosteatosis

Schlüsselwörter
muscle mass, liver transplantation, myosteatosis, skeletal muscle index, GLIM score