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Bedside Ultrasound to Assess for Sarcopenia in Cirrhotic Patients Undergoing Inpatient Liver Transplant Evaluation

M. Aguilar1, E. A. Rodriguez1, A. Andrekus2, S. Buckner-Petty2, N. Dahiya2, E. J. Carey2

1GI/Hepatology, Mayo-Arizona, Scottsdale, AZ, 2Mayo-Arizona, Scottsdale, AZ

Meeting: 2020 American Transplant Congress

Abstract number: D-139

Keywords: Liver, Liver cirrhosis, Liver transplantation, N/A

Session Information

Session Name: Poster Session D: Liver: Recipient Selection

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Sarcopenia is routinely assessed during outpatient evaluation for liver transplant (LT) candidacy in cirrhotic patients as it is associated with poor clinical outcomes. Skeletal muscle index (SMI) measured on computed tomography (CT) is the gold standard, however this may not be feasible in the inpatient setting. There is a paucity of data evaluating the use of bedside ultrasound (US), a quick and readily accessible tool, to assess for sarcopenia in this patient population. We examined the correlation of rectus femoris (RF) and vastus lateralis (VL) muscle mass on US to SMI on CT for sarcopenia assessment in patients undergoing inpatient LT evaluation.

*Methods: Cirrhotic patients undergoing inpatient LT evaluation from January, 2019 onward were included when abdominal CT was needed for standard of care. Sarcopenia was defined by the FLEXIT criteria as SMI <50 cm2/m2in men and <39 cm2/m2in women. RF and VL muscle mass were acquired using US. Data was analyzed using Spearman’s correlations.

*Results: Ten patients were evaluated thus far. The mean age was 54.6 years and majority of patients were male (80%). Further patient characteristics are provided in Table 1. No female patients had sarcopenia, while 62.5% of males did. Mean SMI for males with sarcopenia was 42.6+6.1, and 56+2.5 for males without sarcopenia. Mean SMI for females was 40.2+1.2. Mean RF for males with sarcopenia was 1+0.5, males without sarcopenia 1.3+0.1, females 1.1+0.1. Mean VL for males with sarcopenia was 1.5+0.8, males without sarcopenia 1.7+0.2, females 1.3+0.2. Mean of means (RF and VL) for males with sarcopenia was 1.2+0.6, males without sarcopenia 1.5+0.1, females 1.2+0.1. Overall, a moderate correlation was observed for RF versus SMI (rho=0.42) and for the mean of means versus SMI (rho=0.32). There was no correlation for VL versus SMI.

*Conclusions: There is a moderate correlation noted when evaluating SMI on CT versus RF and mean of means on US. US is an inexpensive and easily obtainable bedside test that can serve as a surrogate to CT to assess muscle mass in hospitalized cirrhosis patients undergoing evaluation for LT.

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To cite this abstract in AMA style:

Aguilar M, Rodriguez EA, Andrekus A, Buckner-Petty S, Dahiya N, Carey EJ. Bedside Ultrasound to Assess for Sarcopenia in Cirrhotic Patients Undergoing Inpatient Liver Transplant Evaluation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/bedside-ultrasound-to-assess-for-sarcopenia-in-cirrhotic-patients-undergoing-inpatient-liver-transplant-evaluation/. Accessed May 16, 2025.

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