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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Impact of sarcopenia on mortality in patients undergoing liver re-transplantation
Amaninder Dhaliwal, Diana Larson, Molly Hiat, Lyudmila M Muinov, William L Harrison, Harlan Sayles, Tomoki Sempokuya, Marco A Olivera, Fedja A Rochling, Timothy M McCashland
Amaninder Dhaliwal, Department of Gastroenterology and Hepatology, University of South Florida and Moffitt Cancer Center, Tampa, FL 33612, United States
Diana Larson, Tomoki Sempokuya, Marco A Olivera, Fedja A Rochling, Timothy M McCashland, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Molly Hiat, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Lyudmila M Muinov, Department of Radiology, University of Nebraska Medical Center, Omaha, NE 68198, United States
William L Harrison, Division of Abdominal Imaging, Department of Radiology, University of Nebraska Medical Center, Omaha, NE 68198, United States
Harlan Sayles, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States
Author contributions: Dhaliwal A was the guarantor of the article and designed the research study; Dhaliwal A and Larson D involved in data collection; Sayles H contributed statistical analysis; all authors were involved with data interpretation, drafting, editing, and critical revision of this manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Review Board (IRB# 236-17-EP).
Informed consent statement: Informed consent was not required to conduct this study.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available upon request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Amaninder Dhaliwal, MD, Academic Fellow, Doctor, Division of Gastroenterology and Hepatology, University of South Florida and Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States.
dramaninderdhaliwal@gmail.com
Received: April 11, 2020
Peer-review started: April 11, 2020
First decision: April 26, 2020
Revised: July 27, 2020
Accepted: October 5, 2020
Article in press: October 5, 2020
Published online: October 27, 2020
Processing time: 195 Days and 7.7 Hours
ARTICLE HIGHLIGHTS
Research background
Sarcopenia, which is a loss of skeletal muscle mass, has been reported to increase post-transplant mortality and morbidity in patients undergoing the first liver transplant. Cross-sectional imaging modalities typically determine sarcopenia in patients with cirrhosis by measuring core abdominal musculatures.
Research motivation
Identification of sarcopenia is becoming more prevalent in the initial liver transplantation. However, there is limited evidence for sarcopenia related outcomes in patients undergoing liver re-transplantation (re-OLT).
Research objectives
The study aimed to evaluate the risk of mortality in patients with pre-existing sarcopenia following liver re-OLT.
Research methods
This is a retrospective study of patients who had undergone a liver re-OLT. The presence of sarcopenia was determined by the Psoas Muscle Area on cross-sectional imaging. The primary outcome was to compare 90 d, one, and 5-year survival rates between sarcopenia and no sarcopenia group.
Research results
Overall, 47% of patients who underwent re-OLT had sarcopenia. Biological markers, outcome parameters, and survival at 90 d, 1 and 5 years, were similar between the two groups. Sarcopenia in re-OLT at our center was noted to be twice as common as historically reported in patients undergoing primary liver transplantation.
Research conclusions
Overall survival and outcome parameters were no different in those with and without the evidence of sarcopenia after re-OLT.
Research perspectives
Although sarcopenia has been shown to predict the outcomes after the first liver transplantation, our study did not show the difference in survival and outcome parameters between sarcopenia and non-sarcopenia groups. Besides, sarcopenia was more prevalent in patients undergoing re-OLT compared to initial transplantation. Larger prospective studies are needed to assess the impact of sarcopenia in patients undergoing re-OLT.
