Renal dysfunction independently predicts muscle mass loss in patients following liver transplantation
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Canadian liver journal
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University of Toronto Press
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Mots-clés
- Cirrhosis
- Liver transplantation
- Renal dysfunction
- Sarcopenia
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Résumé
Résumé
Liver transplantation (LT) is the only curative treatment for cirrhosis. However, the presence of
complications can impact outcomes following LT. Sarcopenia, or muscle mass loss, is highly prevalent in patients with
cirrhosis and is associated with longer hospitalization stays and a higher infection rate post-surgery. We aimed to identify
patients at higher risk of early sarcopenia post-LT. METHODS: This retrospective study included 79 cirrhotic patients
who underwent LT. Muscle mass was evaluated using the third lumbar spine vertebra skeletal muscle mass index
(SMI) and sarcopenia was defined using established cut-off values. Computerized tomography (CT) scans performed
within six-month peri-operative period (three months pre- and post-LT) were included in the study. Complications and
comorbidities were collected and correlated to SMI post-LT and predictive models for SMI post-LT were constructed.
RESULTS: The overall prevalence of sarcopenia was 46% and 62% before and after LT, respectively. Newly developed
sarcopenia was found in 42% of patients. Post-LT sarcopenia was associated with longer hospital stays (54±37 vs 29±10
days, p = 0.002), higher number of infection (3±1 vs 1±2, p = 0.027), and greater number of complications (5±2 vs 3±2,
p <0.001) compared to absence of sarcopenia. Multivariate analyses showed that the SMI post-LT was independently
associated with pre-LT renal function markers, the glomerular filtration rate (GFR) and creatinine (Model 1, GFR: β =
0.33; 95% CI = 0.04–0.17; p = 0.003; Model 2, Creatinine: β = –0.29; 95% CI = –0.10 to –0.02; p = 0.009). CONCLUSIONS:
The present study highlights the potential role of renal dysfunction in the development and persistence of sarcopenia
after LT.
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