Muscle quality determined by computed tomography predicts short-term and long-term survival after liver transplantation

• Published in: Scientific reports Vol. 13; no. 1; p. 7631
• Main Authors: Molwitz, Isabel, Recklies, Franziska, Stark, Maria, Horvatits, Thomas, Salamon, Johannes, Huber, Samuel, Fischer, Lutz, Adam, Gerhard, Lohse, Ansgar W., Sterneck, Martina, Horvatits, Karoline
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10-05-2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/308/409; 692/4020; 692/4020/4021; 692/700/1750; 692/700/2814; Computed tomography; Humanities and Social Sciences; Humans; Liver; Liver diseases; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; Male; multidisciplinary; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - pathology; Muscular Diseases - pathology; Retrospective Studies; Sarcopenia; Sarcopenia - etiology; Science; Science (multidisciplinary); Survival; Tomography; Tomography, X-Ray Computed; Transplants & implants
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-33349-y

Sarcopenia, the loss of muscle mass and quality, contributes to worse clinical outcome in patients with end-stage liver disease, but its impact on short- and long-term survival remains insufficiently understood. The aim of this study was to evaluate the development of computed tomography (CT) muscle parameters and their impact on short-term and long-term survival after liver transplantation. This retrospective study included patients with liver transplantation between 2011 and 2015 and a pre-transplant CT scan. Clinical characteristics, CT muscle mass and density were assessed pre-transplant, and in available CT scans at short-term (11 months) and long-term follow-up (56 months). Overall, 93/152 (61%) patients (109 male, 55 ± 10 years) suffered from sarcopenia pre-transplant. In short- (n = 50) and long-term follow-up (n = 52) the muscle mass (− 2.65 cm
2
/m
2
95% CI [− 4.52, − 0.77], p = 0.007; − 2.96 cm
2
/m
2
[− 4.7, − 1.23], p = 0.001, respectively), and muscle density (− 3 HU [− 6, − 1], p = 0.007; − 2 HU [− 4, 0], p = 0.069) decreased. Myosteatosis was associated with a higher post-transplant mortality (survival probability: 3 months 72% vs. 95%, 1 year 63% vs. 90%, 5 years 54% vs. 84%, p = 0.001), while muscle mass was not. In conclusion, muscle mass and quality did not improve after transplant. Muscle quality predicts short- and long-term survival and could help to identify a patient’s risk profile.