Date: Sunday, May 3, 2015
Session Time: 4:00pm-5:30pm
Presentation Time: 5:00pm-5:12pm
Location: Room 115-AB
Introduction: Calculations used to determine expected survival post-liver transplant (OLT) are in part based on pre-OLT functional status. Functional status is subjectively measured by Karnofsky Index (KI) and correlates poorly with mortality in the highest acuity candidates. We sought to determine whether degree of sarcopenia as measured by average psoas area could better predict risk of post-OLT mortality within a subset of high model of end-stage liver disease (MELD) score candidates.
Methods: We retrospectively evaluated 57 patients with MELD scores ≥2549 who were transplanted 2008-2013 with pre-transplant cross sectional imaging and KI ≤40%. Muscle mass was measured as average psoas area at L3. Patients were divided into tercile groups based on high (10.13 cm2 [Group A]), medium (6.29 cm2 [Group B]), and low (4.39 cm2 [Group C]) mean psoas areas. Post-operative outcomes including mortality, time to KI >70%, and post-OLT ICU length of stay (LOS) were compared.
Results: Despite equivalent MELD and KI's between all terciles (Table 1), Group C mortality was highest (35.3% vs 10.0% in A and B, p<0.05). There was no statistical significance between groups for Days to KI >70%, however, a trend exists for longer time in Group C compared to Groups A and B. ICU LOS was significantly less in Group C compared to Groups A and B (p<0.05).
|Tercile Group||Mean psoas area(cm2)||Mean MELD [SD]||Mortality (%)||ICU LOS (days [SD]||Time to >70% Karnofsky index (days [SD])||Mean Karnofsky Index at listing|
|A (n=20)||10.13||37 ||10||27.1||183.1 ||45|
|B (n=20)||6.29||38 ||10||26.6||148.1 [127.4]||45|
|C (n=17)||4.39||35 ||35.3||18.8||248 [303.6]||41|
To cite this abstract in AMA style:Nolte J, Burroughs SGordon, Victor D, Mobley C, Yu N, Hirase T, Saharia A, Rajaraman A, Moore L, Gaber A, Ghobrial R. Muscle Mass Measurement Is Objective and More Predictive of Expected Mortality Than Functional Status in High MELD Liver Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/muscle-mass-measurement-is-objective-and-more-predictive-of-expected-mortality-than-functional-status-in-high-meld-liver-transplant-recipients/. Accessed April 15, 2021.
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