Utility of Preoperative Computed Tomography–Based Body Metrics in Relation to Postoperative Complications in Pediatric Liver Transplantation Recipients

Abstract

Utility of preoperative CT-based body metrics in relation to postoperative complications in pediatric liver transplant recipients.

Perspectives on Sarcopenia as a Predictor for Outcomes in Pediatric Patients with Chronic Liver Disease

“… 31 , 33 While Takeda et al found a correlation between sarcopenia and increased vascular post-transplant complications in biliary atresia patients (specifically portal vein stenosis, with an incidence of 19.0% in the sarcopenia group vs 5.9% of the non-sarcopenia group), 36 this was not seen in other, more heterogeneous transplant cohorts. 31 , 33 , 35 Similarly, Jitwongwai et al found that re-operation occurred in 38.9% of the low muscle mass group vs 15.4% of the high muscle mass group, 40 a finding which was not otherwise replicated. 31 , 35 No studies found an increased risk for post-transplant biliary complications 31 , 33 , 35 , 36 or rejection 33 , 35–37 in sarcopenic patients.…”

“…In these studies, the prevalence of sarcopenia in the pre-transplant population was reported to be 24–56%. 33 , 35 , 36 , 40 The remaining four studies were descriptive, cross-sectional reports in pre-transplant patients which did not define sarcopenia but evaluated tPMSA or PMI as continuous variables in comparison to other patient characteristics. 12 , 28 , 29 , 31 …”

“… 40 No studies have found a significant correlation between sarcopenia and Pediatric End-Stage Liver Disease (PELD) scores. 29 , 31 , 33 , 35 , 36 , 40 …”

“… 31 , 33 , 36 With the exception of Jitwongwai et al, 40 a statistically significant increase in ICU LOS was found in multiple studies. 33 , 35 , 37 However, the clinical significance of this finding varied greatly; while Woolfson et al reported a median ICU LOS of 3.5 days in the sarcopenia group vs 2.0 days in the non-sarcopenia group 33 Mager et al reported approximately 20 vs 7.5 days in the ICU. 37 Notably, the significant findings in Verhagen et al regarding ICU and hospital LOS were weak (with correlation coefficient of R = −0.3 for both outcomes) and only seen in patients below 1 year of age.…”

“… 37 Notably, the significant findings in Verhagen et al regarding ICU and hospital LOS were weak (with correlation coefficient of R = −0.3 for both outcomes) and only seen in patients below 1 year of age. 35 …”