Effect of pre‐transplant sarcopenia on the estimation of standard liver volume in living‐donor liver transplant candidates: risk factor for post‐transplant small‐for‐size syndrome? A retrospective study

Abstract

The aim of the present study was to investigate whether LT candidates with sarcopenia are at an increased risk of receiving an inappropriate standard liver volume (SLV) estimation by standard body weight (BW)-derived SLV formula. Non-BW-SLV estimation formulas were tested in 262 LDLT donors and compared to a standard BW-SLV formula. The anthropometric parameters used were the thoracic width (TW-SLV) and thoracoabdominal circumference (TAC-SLV). Subsequently, sarcopenic and non-sarcopenic LDLT candidates (total, 217 patients) were compared in terms of estimated BW-SLV (routine method) and non-BW-SLV. In donors, TW-SLV showed comparable concordance with CT scan measured total liver volume as BW-SLV. The performance of TAC-SLV was low. In recipients, the prevalence of pre-LT sarcopenia was 30.4%. Sarcopenic patients were attributed a significantly lower BW-SLV than non-sarcopenic (sarcopenia vs no-sarcopenia, 1063.8 ml [1004.1-1118.4] vs. 1220.7 ml [1115.0-1306.6], P < 0.001), despite comparable TW-SLV, age, body height, and gender prevalence. As a result, sarcopenic patients received a graft with a statistically lower weight at organ procurement and developed more frequently a small-for-size syndrome (SFSS) according to the Dahm et al. (27.7% vs. 6.8%, P < 0.01) and Kyushu (28.7% vs. 9.2%, P < 0.01) definition. Therefore, In sarcopenic patients, BW-SLV formulas are affected by an high risk of SLV underestimation, thus exposing them to an increased risk of post-LT SFSS.

Investigation of the prognostic value of psoas muscle area measurement in pediatric patients before liver transplantation: A single‐center retrospective study

“…Pre‐LT sarcopenia is considered to be a factor that negatively affects the outcomes of treatment 11 . Sarcopenia has been found to be associated with reduced survival after LT and prolonged hospital stay 12,13 . However, there are few studies investigating the post‐transplantation effects of the presence of sarcopenia in pediatric patients before LT.…”

“…11 Sarcopenia has been found to be associated with reduced survival after LT and prolonged hospital stay. 12,13 However, there are few studies investigating the post-transplantation F I G U R E 1 First, the L4/5 level was determined from sagittal reformatted images (A). Second, the psoas muscle area was measured from axial images (B) effects of the presence of sarcopenia in pediatric patients before LT.…”

Association between hospital acquired disability and post-discharge mortality in patients after living donor liver transplantation

“…Our previous studies reported that sarcopenia was not related to short-term prognosis of LDLT patients [ 13 , 14 ]. It is possible that HAD with physical activity is more important than sarcopenia in terms of long-term mortality.…”

“…Therefore, it is important to prevent sarcopenia to potentially improve the overall treatment of patients undergoing LDLT [12]. However, previous studies have reported that sarcopenia is not related to prognosis of LDLT [13,14]. Therefore, the association between sarcopenia and prognosis in LDLT patients is still controversial and far from being elucidated.…”

Triphase contrast-enhanced CT to evaluate indications for autologous liver transplantation in patients with end-stage hepatic alveolar echinococcosis

“…All the images were corrected layer by layer to obtain the accurate boundary of the lesion and the liver. In addition, SLV estimation was based on the formula in consideration of body surface area (BSA) 16 : SLV = 706.2 × BSA + 2.4, where BSA was calculated in consideration of height in centimeter and body weight (BW) in kilogram using the Dubois formula: BSA = 0.007184 × Height 0.725 × BW 0.4253 . Ultimately, the ratio of RLV to SLV (RLV/SLV) could be obtained.…”