Sarcopenia in high acuity liver transplantation: Does it predict outcomes?

Area of Science:

• Hepatology
• Transplantation Surgery
• Geriatrics

Background:

• Sarcopenia is increasingly recognized as a prognostic indicator in liver transplantation (LT).
• The role of sarcopenia in high-acuity LT recipients with elevated Model for End-Stage Liver Disease (MELD) scores requires further investigation.

Purpose of the Study:

• To evaluate the impact of sarcopenia on outcomes in liver transplant recipients with high MELD scores.
• To determine if sarcopenia influences post-transplant complications and survival in this patient group.

Main Methods:

• Retrospective analysis of 296 LT patients.
• Sarcopenia assessed using skeletal muscle index (SMI) derived from CT scans within 30 days of LT.
• Sex-specific SMI cut-offs were established and analyzed in patients with MELD ≥ 35.

Main Results:

• In patients with MELD ≥ 35, low SMI (<30 cm²/m² for men, <34 cm²/m² for women) correlated with increased rates of bacteremia and longer hospital stays.
• No significant association was found between sarcopenia and survival in either men or women with MELD ≥ 35.

Conclusions:

• Decreased SMI in high MELD liver transplant recipients is associated with prolonged hospitalization but not with patient survival.
• Sarcopenia assessment may guide perioperative care planning for high-risk LT candidates, rather than solely for patient selection.