IMPACT OF PRE-TRANSPLANT SARCOPENIA ON POST-LIVER TRANSPLANT OUTCOMES A PROSPECTIVE COHORT STUDY

Abstract

Background: Sarcopenia is muscle wasting and loss of muscle strength; often occurs to patients with end-stage liver disease who have been waiting to receive transplants. It has been linked to raised morbidity and mortality. With liver transplantation being the definitive therapy of most of these patients, it is important to establish the effect of sarcopenia on pre-transplantation on the patient outcomes after the transplantation to enhance clinical decision-making and patient treatment.

Objectives: To determine how pre-transplant sarcopenia contributes to post liver transplant morbidity, length of stay, graft functions, and survival in adult liver transplant patients.

Study design: A prospective cohort study.

Place and duration of study: Gambat institute of medical sciences liver transplant and hepatoprncaeqtobiliary ward from jan 2023 to dec 2023

Methods:

This prospective cohort study Conducted in Gambat institute of medical sciences liver transplant and hepatoprncaeqtobiliary ward from jan 2023 to dec 2023 involved the use of adult patients receiving liver transplantation.Sarcopenia was pre-transplant measured by CT-based skeletal muscle index (SMI) at L3 vertebra level. Patients were divided into sarcopenia and non sarcopenia groups. We compared post-transplant outcomes such as length of stay in intensive care, infection rates, graft function, and 1-year survival compared using relevant statistical test (t-test, chi-square, and Cox regression).

Results:

300 patients included. The average age comprised 54.6 +/- 9.8 years. Pre-transplant sarcopenia (n=042) was a diagnosis in 42 percent. Patients with sarcopenia spent much more time in the ICU than control patients (5.8 +/- 2.3 vs 3.1 +/-1.9 days, p= 0.004), were more likely to develop one or more infections during their stay (35.7% vs 18.9%, p=0.03), and died within 1 year (21.4% vs 8.6%, p=0.02). There was no meaningful disparity in 1-year graft survival (p=0.41).

Conclusion:

There is evidence that Pre-transplant sarcopenia is linked with lesser short-term outcomes after liver transplantation, such as prolonged ICU-stays, infections, and death. The early identification and treatment of sarcopenia can help in improving post-transplant outcomes and recovery. Nutritional and physical rehabilitation approaches used in transplant candidates may lower complications and enhance survival.