*Purpose: Sarcopenia and obesity are common among transplant and hepatobiliary patients; however, current methods of measuring these risk factors may provide an inadequate representation of their impact on adverse outcomes. Bioelectrical impedance analysis (BIA) is an emerging tool that can quickly measure body composition to assess obesity and sarcopenia. This study aimed to assess clinical utility of BIA in transplant and hepatobiliary populations.

*Methods: We conducted a single-center study of 60 patients (5 living donor candidates, 10 early post-operative, 7 benign liver disease, 14 chronic kidney disease, 5 early cirrhosis, 7 post-transplant, 6 early malignancy, and 6 advanced malignancy). Sarcopenia was defined as patients with a calculated whole-body muscle mass (kg)/body surface area below the 25th percentile. Obesity was defined as fat percentage of >25% and >30% in males and females, respectively. Patients were categorized into 4 groups: (1) not sarcopenic/not obese, (2) sarcopenic/not obese, (3) not sarcopenic/obese, and (4) sarcopenic/obese. Clinical characteristics and BIA were compared.

*Results: The 60 participants were grouped as: 28 not sarcopenic/not obese, 1 sarcopenic/not obese, 17 not sarcopenic/obese, and 14 sarcopenic/obese. There was no significant differences in BMI, albumin, total protein, and absolute lymphocyte count. Sarcopenic/obese patients showed significantly lower Karnofsky score (median 55% [IQR, 50-82.5%]), compared to not sarcopenic/obese patients (median 80% [IQR, 60-92.5%]) (P =0.037). All patients with advanced malignancy were either sarcopenic/not obese or sarcopenic/obese.

*Conclusions: Patients who were sarcopenic/obese showed significantly lower performance status than patients who were not sarcopenic/obese. BIA may serve as a useful tool in assessing sarcopenia and obesity to identify patients who are at risk of muscle wasting and frailty.

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