Impact of sarcopenia on outcomes in liver transplant recipients: a nationwide analysis

Sarcopenia is linked to adverse outcomes in patients undergoing liver transplantation (LT), including higher post-transplant complication rates and mortality rates. The current study aims to assess the impact of sarcopenia on outcomes in LT recipients.

The National Inpatient Sample Database 2016-2020 was used to identify LT recipients. Patients were categorized into two groups based on the presence or absence of sarcopenia. Data were collected on patient demographics, etiology of liver disease, and decompensation of liver disease. The outcomes studied include in-hospital mortality, shock, acute kidney injury (AKI), ICU stay, and LT-related complications. The impact of sarcopenia was assessed using multivariate logistic/linear regression analysis.

Of the 170 650 LT recipients included in the analysis, 24 525 (14.4%) had sarcopenia. After adjusting for confounding factors, sarcopenia was associated with a higher odds of in-hospital mortality [adjusted odds ratio (aOR), 2.16; 95% confidence interval (CI), 1.83-2.56; P  < 0.001], shock (aOR, 2.18; 95% CI, 1.92-2.48; P  < 0.001), AKI (aOR, 1.4; 95% CI, 1.32-1.49; P  < 0.001), ICU stay (aOR, 2.23; 95% CI, 1.98-2.52; P  < 0.001), LT-related complications (aOR, 1.47; 95% CI, 1.23-1.75; P  < 0.001), longer length of stay (adj. coefficient, 4.71 days; 95% CI, 4.31-5.10; P  < 0.001), and total hospitalization charges (adj. coefficient-$56 359.88; 95% CI, $49 737.17-$62 982.58; P  < 0.001).

We noted that sarcopenia is associated with worse outcomes and higher resource utilization in LT recipients, highlighting the need for early detection and targeted interventions.