Effects Of Sarcopenia On The Prognosis Of Liver Transplantation Patients

Objective: to evaluate the prevalence of sarcopenia in patients undergoing liver transplantation at our hospital,and further evaluate their influence on the prognosis after liver transplantation,including their mechanical ventilation time,ICU stay time and length of hospital stay and mortality rate of 90 days,and observing the outcome of sarcopenia after liver transplantation.Methods:1.A retrospective analysis was conducted on 44 consecutive liver transplantation patients who received liver transplantation at the Department of Hepatobiliary Surgery,Third Hospital of Hebei Medical University between November 2019 and November 2020.2.Patients without a third lumbar spine(L3)CT scan within 2 weeks preoperatively(n=38)and patients with a history of other surgery(n=1)were excluded from the analysis.Results: 1.According to the diagnostic value of SMI,patients were divided into sarcopenia group(n=21)and non-sarcopenia group(n=23).There were no differences in gender,height,diabetes mellitus,operation time,amount of blood loss,amount of blood transfusion,anhepatic phase,length of hospital stay,MELD score,MELD-Na score and CTP score between the two groups(P > 0.05);2.the ascites quantity,age,ICU stay time and mechanical ventilation time in the sarcopenia group were higher than those in the non-sarcopenia group(P < 0.05),and the weight and BMI of the sarcopenia group were lower than those in the non-sarcopenia group(P < 0.05),however,the ascites quantity,age,BMI、ICU stay time,and mechanical ventilation time had no effect on mortality.There is a moderate correlation between SMI and PMI(Kappa coefficient was 0.456,P < 0.05),however,the diagnostic value of PMI was not statistically significant for the prognosis(including postoperative survival)of liver transplantation patients;3.After liver transplantation,skeletal muscle mass continued to decrease in the majority of patients,including 3 patients who were newly developed.At follow-up,the 90-day survival rate was 81% in the sarcopenia group and 100% in the non-sarcopenia group.Conclusions:1.In this study,sarcopenia may affect patient outcomes,including ICU stay time,mechanical ventilation duration,and survival,independent of MELD and CTP scores.2.Muscle mass loss progresses during transplantation and persists even after liver transplantation in many patients.