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Muscle mass predicts outcomes following liver transplantation
Author(s) -
DiMartini Andrea,
Cruz Ruy J.,
Dew Mary Amanda,
Myaskovsky Larissa,
Goodpaster Bret,
Fox Kristen,
Kim Kevin H.,
Fontes Paulo
Publication year - 2013
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23724
Subject(s) - medicine , body mass index , context (archaeology) , intensive care unit , sarcopenia , liver transplantation , ascites , lean body mass , intubation , transplantation , muscle mass , intensive care medicine , surgery , body weight , paleontology , biology
For patients with end‐stage liver disease, commonly used indices of nutritional status (ie, body weight and body mass index) are often inflated because of fluid overload (ie, ascites and peripheral edema), and this results in an underdiagnosis of malnutrition. Because muscle is the largest protein reservoir in the body, an estimate of the muscle mass may be a more reliable and valid estimate of nutritional status. Therefore, we used pretransplant computed tomography data for 338 liver transplantation (LT) candidates to identify muscle and fat mass on the basis of a specific abdominal transverse section commonly used in body composition analyses, and we investigated the contribution of this measure to specific post‐LT outcomes. We found that the majority of our patients (68%) could be defined as cachectic. For men, muscle mass predicted many important posttransplant outcomes, including intensive care unit (ICU) stay, total length of stay (LOS), and days of intubation. Muscle mass was a significant predictor of survival and also predicted disposition to home versus another facility. For women, muscle mass predicted ICU stay, total LOS, and days of intubation, but the effect was modest. Muscle mass did not predict survival or disposition for women. In conclusion, because pretransplant muscle mass is associated with many important postoperative outcomes, we discuss these findings in the context of possible pretransplant interventions for either improving or sustaining muscle mass before surgery. Liver Transpl 19:1172‐1180, 2013 . © 2013 AASLD.