Background: Skeletal muscle depletion has been shown to be an independent predictor of lower overall survival in various diseases. In surgical fields, however, the significance of other body components including visceral and subcutaneous adipose tissue remains unclear. The present study investigated the impact of adipose tissue as well as skeletal muscle on outcomes in patients undergoing living donor liver transplantation (LDLT).

Patients and Methods: This study comprised 250 adult patients undergoing LDLT between January 2008 and April 2015. Using preoperative CT imaging, the quantity and quality of skeletal muscle were evaluated by skeletal muscle mass index (SMI) and intramuscular adipose tissue content (IMAC) at the third lumber vertebra, respectively. At the same level, visceral to subcutaneous adipose tissue area ratio (VSR) was calculated. 1) The correlations among SMI, IMAC and VSR, 2) the overall survival rate in patients classified according to SMI, IMAC or VSR, and 3) the risk factors for poor survival after LDLT were analyzed.

Results: 1) There was a significantly negative relationship between SMI and VSR in both males (r = -0.371, p < 0.001) and females (r = -0.291, p = 0.001). 2) The overall survival rate in patients with low SMI (p < 0.001), high IMAC (p < 0.001), or high VSR (p < 0.001) was significantly lower than in each normal group. 3) Multivariate analysis revealed that preoperative low SMI (Odds ratio [OR] = 2.745, p < 0.001) and high VSR (OR = 4.761, p < 0.001) were independent risk factors for death after LDLT.

Conclusion: Low SMI and high VSR were closely involved with posttransplant mortality.

CITATION INFORMATION: Hamaguchi Y, Kaido T, Kobayashi A, Okumura S, Yagi S, Okajima H, Uemoto S. Impact of Preoperative Body Composition on Outcomes After Living Donor Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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