Endocrine Abstracts

Background: Evidence suggests that muscle mass depletion is associated with poor clinical outcomes in clinical population. However, the significance of sarcopenia in the liver transplantation (LT) population remains unclear. The purpose of this study is to investigate the prevalence and the impact of sarcopenia and sarcopenic obesity in cirrhosis patients awaiting LT.

Methods: We retrospectively analyzed patients who underwent LT at our center between January 2013 to January 2019. Data analysis was performed from October 2019 to December 2019. Body composition parameters including skeletal muscle mass index (SMI) and visceral fat area (VFA) were evaluated by preoperative plain computed tomography imaging at the level of the third lumbar vertebra (L3) and also clinical and biochemical parameters were taken. Sarcopenia was defined using FLEXIT cut-points (SMI: male < 50 cm²/m²; female < 39 cm²/m²) and obesity a VFA > 130 cm². Cox regressions and Kaplan-Meier analysis was performed.

Results: The study included 137 patients (108 men) with a mean age of 57,4 (s.d. 9,05),83 (60,6%) had sarcopenia and 29 (21.2%) had sarcopenic obesity. Multivariate analysis identified low SMI as independent risk factor for death after LT [OR 8,293 (3,284–20,040) P < 0.0001].

Conclusions: Preoperative sarcopenia is an important independent predictor of post-liver transplantation mortality in cirrhosis patients. A high SMI is an excellent predictor for survival in this group of patients.