Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2023 Jun 21;57(2):168-177. doi: 10.2478/raon-2023-0025. eCollection 2023 Jun 1.
Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of radiologically assessed skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes.
Data of 138 adult patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in computer tomography (CT) scan at the third lumbar vertebra level were calculated. Results were analyzed for the length of hospitalisation and postoperative outcomes.
In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer intensive care unit (ICU) stay (P < 0.025). Low SMI had no influence on ICU stay in female patients (P = 0.544), length of hospitalisation (male, P > 0.05; female, P = 0.843), postoperative complication rates (males, P = 0.883; females, P = 0.113), infection rate (males, P = 0.293, females, P = 0.285) and graft rejection (males, P = 0.875; females, P = 0.135). The presence of MI did not influence ICU stay (P = 0.161), hospitalization (P = 0.771), postoperative complication rates (P = 0.467), infection rate (P = 0.173) or graft rejection rate (P = 0.173).
In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation. CT body composition analysis of recipients and uniformly accepted cut-off points are crucial to producing reliable data in the future.
肝移植为急性和慢性终末期肝病患者提供了治愈性治疗。营养状况对肝移植术后结局的影响仍知之甚少。本研究探讨了影像学评估骨骼肌指数（SMI）和肌内脂肪（MI）对术后结局的预测价值。
回顾性分析了 138 例接受首次原位肝移植的成年患者的数据。在第 3 腰椎水平的计算机断层扫描（CT）扫描中计算 SMI 和 MI。分析结果与住院时间和术后结果有关。
在 63%的男性和 28.9%的女性受者中发现低 SMI。45（32.6%）例患者发现高 MI。高 SMI 的男性患者 ICU 停留时间较长（P<0.025）。低 SMI 对女性患者的 ICU 停留时间没有影响（P=0.544），住院时间（男性，P>0.05；女性，P=0.843），术后并发症发生率（男性，P=0.883；女性，P=0.113），感染率（男性，P=0.293，女性，P=0.285）和移植物排斥率（男性，P=0.875；女性，P=0.135）。MI 的存在并不影响 ICU 停留时间（P=0.161）、住院时间（P=0.771）、术后并发症发生率（P=0.467）、感染率（P=0.173）或移植物排斥率（P=0.173）。
在我们的研究中，SMI 和 MI 观察到的肝移植受者的身体成分变化对肝移植后的术后过程没有影响。受体的 CT 体成分分析和统一接受的临界点对于未来产生可靠的数据至关重要。
