Universität zu Köln

Dos Santos, Daniel Pinto, Kloeckner, Roman, Koch, Sandra, Hoppe-Lotichius, Maria, Zoeller, Daniela, Toenges, Gerrit, Kremer, Wolfgang Maximilian, Zimmermann, Tim, Mittler, Jens, Lang, Hauke, Dueber, Christoph, Galle, Peter Robert, Weinmann, Arndt and Sprinzl, Martin Franz (2020). Sarcopenia as prognostic factor for survival after orthotopic liver transplantation. Eur. J. Gastroenterol. Hepatol., 32 (5). S. 626 - 635. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5687

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Abstract

Background and aim Body composition has emerged as a prognostic factor for end-stage liver disease. We therefore investigated muscle mass, body fat and other clinical-pathological variables as predictors of posttransplant survival. Methods A total of 368 patients, who underwent orthotopic liver transplantation (OLT) at our institution, were assessed prior to OLT and followed for a median of 9.0 years (range 2.0-10.0 years) after OLT. Psoas, erector spinae and the combined paraspinal muscle area, as well as the corresponding indices normalized by body-height squared, were quantified by a lumbar (L3) cross-sectional computed tomography. In addition, absolute body fat and bone density were estimated by the same computed tomography approach. Results Paraspinal muscle index (PSMI) (hazard ratio 0.955, P = 0.039) and hepatitis C (hazard rati 1.498, P = 0.038) were independently associated with post-OLT mortality. In contrast, body fat and bone density did not significantly affect post-OLT outcome (P > 0.05). The PSMI also predicted one-year posttransplant mortality with a receiver operating characteristics-area under the curve of 0.671 [95% confidence interval (CI) 0.589-0.753, P < 0.001) in male patients and outperformed individual psoas and erector spinae muscle group assessments in this regard. In male patients, a defined PSMI cutoff (<18.41 cm(2)/m(2)) was identified as suitable determinant for sarcopenia and posttransplant one-year mortality. In female OLT-recipients, however, sarcopenia was not predictive for patient survival und a women-specific cutoff could not be derived from this study. Conclusions Taken together this analysis provides evidence, which PSMI is a relevant marker for muscle mass and that sarcopenia is an independent predictor of early post-OLT survival in male patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoppe-Lotichius, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Toenges, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Kremer, Wolfgang Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmermann, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Mittler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Hauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueber, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Galle, Peter Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Weinmann, Arndt UNSPECIFIED UNSPECIFIED UNSPECIFIED Sprinzl, Martin Franz UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-335060
DOI:	10.1097/MEG.0000000000001552
Journal or Publication Title:	Eur. J. Gastroenterol. Hepatol.
Volume:	32
Number:	5
Page Range:	S. 626 - 635
Date:	2020
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5687
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUBJECTIVE GLOBAL ASSESSMENT; SEVERE MUSCLE DEPLETION; NUTRITIONAL-STATUS; BODY-COMPOSITION; SKELETAL-MUSCLE; CIRRHOSIS; OUTCOMES; PREDICT; MODEL; MALNUTRITION Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33506