Miarka Maciej, Gibiński Krzysztof, Janik Maciej K, Główczyńska Renata, Zając Krzysztof, Pacho Ryszard, Raszeja-Wyszomirska Joanna
Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland.
II Department of Clinical Radiology, Medical University of Warsaw, 02-091 Warsaw, Poland.
Life (Basel). 2021 Jul 24;11(8):740. doi: 10.3390/life11080740.
Optimizing patients' condition before liver transplantation (LT) could potentially improve survival of LT patients. We focused on sarcopenia, as a common factor in liver transplant candidates that can impact their cardiopulmonary performance at the point of listing, morbidity, and mortality after LT. We performed a single-center cohort study on 98 consecutive patients with liver cirrhosis who were transplanted between March 2015 and December 2017. The third lumbar vertebra skeletal muscle index (L3SMI) was calculated using CT imaging to distinguish sarcopenia at listing for LT. Data regarding liver function, body mass index (BMI), cardiac biomarkers, the peak oxygen uptake (VO2) and LT outcome were collected and correlated to L3SMI. For data analysis the Dell Statistica (Version 13. Dell Inc., Rondrock, TX, USA) was used. In total, 98 cirrhotic patients were included. Fifty-five (56.1%) patients, mostly males, had sarcopenia according to L3SMI, with the lowest L3SMI in males with alcohol-related liver disease. Lower L3SMI correlated with lower BMI, lower VO2 peak, and higher NTproBNP (all < 0.001) and revealed an essential correlation with prolonged ICU stay (r = -0.21, < 0.05). 33 patients were unable to perform cardio-pulmonary exercise test, mostly sarcopenic (67%), with more advanced liver insufficiency (assessed with CPC and MELD scores) and longer stay at ICU after LT (all < 0.001). Sarcopenia was common among LT recipients. It was associated with inferior result in cardio-pulmonary performance before LT and prolonged ICU stay after grafting.
在肝移植（LT）前优化患者病情可能会提高LT患者的生存率。我们关注肌肉减少症，因为它是肝移植候选者中的一个常见因素，会在列入名单时影响他们的心肺功能、发病率以及LT后的死亡率。我们对2015年3月至2017年12月间连续接受移植的98例肝硬化患者进行了单中心队列研究。使用CT成像计算第三腰椎骨骼肌指数（L3SMI），以区分LT列入名单时的肌肉减少症。收集了有关肝功能、体重指数（BMI）、心脏生物标志物、峰值摄氧量（VO2）和LT结果的数据，并将其与L3SMI进行关联。数据分析使用了戴尔统计软件（版本13。戴尔公司，美国得克萨斯州朗德罗克）。总共纳入了98例肝硬化患者。根据L3SMI，55例（56.1%）患者存在肌肉减少症，其中酒精性肝病男性患者的L3SMI最低。较低的L3SMI与较低的BMI、较低的VO2峰值以及较高的NTproBNP相关（均P<0.001），并显示出与ICU住院时间延长存在显著相关性（r=-0.21，P<0.05）。33例患者无法进行心肺运动试验，其中大多数为肌肉减少症患者（67%），肝功能不全更严重（根据CPC和MELD评分评估），LT后在ICU的停留时间更长（均P<0.001）。肌肉减少症在LT受者中很常见。它与LT前心肺功能较差以及移植后ICU住院时间延长有关。
