The evolution and impact of sarcopenia pre- and post-liver transplantation

Rahima A. Bhanji, Naoki M Takahashi, Michael R. Moynagh, Praveena Narayanan, Mounika Angirekula, Kristin C. Mara, Ross A. Dierkhising, Kymberly D. Watt

Research output: Contribution to journalArticle

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Abstract

Background: Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. Aims: To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. Methods: Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293). Results: Sarcopenia was present in 146/293 (50%) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 ± 4.9 cm 2 /m 2 ; P < 0.001), and an increase in myosteatosis while awaiting liver transplantation. There was no significant change in abdominal visceral fat. For every 1 cm 2 /m 2 decrease in muscle mass there was an increase in post-transplant length of stay by 0.36 days (P = 0.005). Post-transplant, 98/161 (61%) of patients with CT imaging had sarcopenia (25 de novo and 73 persistent), with continued increase in myosteatosis, lower Hounsfield units (−5.0 [IQR −8.6 to 0.1]; P < 0.001) and an increase in abdominal visceral fat (4.9 [IQR −4.4 to 15.6] cm 2 /m 2 ; P < 0.001). There was no statistically significant difference in 1-year mortality in patients with de novo sarcopenia compared to patients with sarcopenia both pre- and post-transplant (HR 1.88; P = 0.088). Conclusions: Sarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.

Original languageEnglish (US)
Pages (from-to)807-813
Number of pages7
JournalAlimentary Pharmacology and Therapeutics
Volume49
Issue number6
DOIs
StatePublished - Mar 1 2019

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Sarcopenia
Liver Transplantation
Transplants
Liver
Intra-Abdominal Fat
Mortality
Length of Stay
Lumbosacral Region
Muscles
Hospitalization

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Bhanji, R. A., Takahashi, N. M., Moynagh, M. R., Narayanan, P., Angirekula, M., Mara, K. C., ... Watt, K. D. (2019). The evolution and impact of sarcopenia pre- and post-liver transplantation. Alimentary Pharmacology and Therapeutics, 49(6), 807-813. https://doi.org/10.1111/apt.15161

The evolution and impact of sarcopenia pre- and post-liver transplantation. / Bhanji, Rahima A.; Takahashi, Naoki M; Moynagh, Michael R.; Narayanan, Praveena; Angirekula, Mounika; Mara, Kristin C.; Dierkhising, Ross A.; Watt, Kymberly D.

In: Alimentary Pharmacology and Therapeutics, Vol. 49, No. 6, 01.03.2019, p. 807-813.

Research output: Contribution to journalArticle

Bhanji, RA, Takahashi, NM, Moynagh, MR, Narayanan, P, Angirekula, M, Mara, KC, Dierkhising, RA & Watt, KD 2019, 'The evolution and impact of sarcopenia pre- and post-liver transplantation', Alimentary Pharmacology and Therapeutics, vol. 49, no. 6, pp. 807-813. https://doi.org/10.1111/apt.15161
Bhanji RA, Takahashi NM, Moynagh MR, Narayanan P, Angirekula M, Mara KC et al. The evolution and impact of sarcopenia pre- and post-liver transplantation. Alimentary Pharmacology and Therapeutics. 2019 Mar 1;49(6):807-813. https://doi.org/10.1111/apt.15161
Bhanji, Rahima A. ; Takahashi, Naoki M ; Moynagh, Michael R. ; Narayanan, Praveena ; Angirekula, Mounika ; Mara, Kristin C. ; Dierkhising, Ross A. ; Watt, Kymberly D. / The evolution and impact of sarcopenia pre- and post-liver transplantation. In: Alimentary Pharmacology and Therapeutics. 2019 ; Vol. 49, No. 6. pp. 807-813.
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title = "The evolution and impact of sarcopenia pre- and post-liver transplantation",
abstract = "Background: Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. Aims: To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. Methods: Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293). Results: Sarcopenia was present in 146/293 (50{\%}) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 ± 4.9 cm 2 /m 2 ; P < 0.001), and an increase in myosteatosis while awaiting liver transplantation. There was no significant change in abdominal visceral fat. For every 1 cm 2 /m 2 decrease in muscle mass there was an increase in post-transplant length of stay by 0.36 days (P = 0.005). Post-transplant, 98/161 (61{\%}) of patients with CT imaging had sarcopenia (25 de novo and 73 persistent), with continued increase in myosteatosis, lower Hounsfield units (−5.0 [IQR −8.6 to 0.1]; P < 0.001) and an increase in abdominal visceral fat (4.9 [IQR −4.4 to 15.6] cm 2 /m 2 ; P < 0.001). There was no statistically significant difference in 1-year mortality in patients with de novo sarcopenia compared to patients with sarcopenia both pre- and post-transplant (HR 1.88; P = 0.088). Conclusions: Sarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.",
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T1 - The evolution and impact of sarcopenia pre- and post-liver transplantation

AU - Bhanji, Rahima A.

AU - Takahashi, Naoki M

AU - Moynagh, Michael R.

AU - Narayanan, Praveena

AU - Angirekula, Mounika

AU - Mara, Kristin C.

AU - Dierkhising, Ross A.

AU - Watt, Kymberly D.

PY - 2019/3/1

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N2 - Background: Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. Aims: To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. Methods: Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293). Results: Sarcopenia was present in 146/293 (50%) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 ± 4.9 cm 2 /m 2 ; P < 0.001), and an increase in myosteatosis while awaiting liver transplantation. There was no significant change in abdominal visceral fat. For every 1 cm 2 /m 2 decrease in muscle mass there was an increase in post-transplant length of stay by 0.36 days (P = 0.005). Post-transplant, 98/161 (61%) of patients with CT imaging had sarcopenia (25 de novo and 73 persistent), with continued increase in myosteatosis, lower Hounsfield units (−5.0 [IQR −8.6 to 0.1]; P < 0.001) and an increase in abdominal visceral fat (4.9 [IQR −4.4 to 15.6] cm 2 /m 2 ; P < 0.001). There was no statistically significant difference in 1-year mortality in patients with de novo sarcopenia compared to patients with sarcopenia both pre- and post-transplant (HR 1.88; P = 0.088). Conclusions: Sarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.

AB - Background: Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. Aims: To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. Methods: Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293). Results: Sarcopenia was present in 146/293 (50%) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 ± 4.9 cm 2 /m 2 ; P < 0.001), and an increase in myosteatosis while awaiting liver transplantation. There was no significant change in abdominal visceral fat. For every 1 cm 2 /m 2 decrease in muscle mass there was an increase in post-transplant length of stay by 0.36 days (P = 0.005). Post-transplant, 98/161 (61%) of patients with CT imaging had sarcopenia (25 de novo and 73 persistent), with continued increase in myosteatosis, lower Hounsfield units (−5.0 [IQR −8.6 to 0.1]; P < 0.001) and an increase in abdominal visceral fat (4.9 [IQR −4.4 to 15.6] cm 2 /m 2 ; P < 0.001). There was no statistically significant difference in 1-year mortality in patients with de novo sarcopenia compared to patients with sarcopenia both pre- and post-transplant (HR 1.88; P = 0.088). Conclusions: Sarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.

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