Myosteatosis to predict inferior perioperative outcome in patients undergoing orthotopic liver transplantation.
Adult
Aged
Body Composition
Female
Follow-Up Studies
Humans
Liver Transplantation
Male
Middle Aged
Multivariate Analysis
Muscular Atrophy
/ complications
Postoperative Complications
/ diagnosis
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Tomography, X-Ray Computed
Transplantation, Homologous
body composition
clinical decision-making
clinical research/practice
complication
liver transplantation/hepatology
myosteatosis
sarcopenia
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
08
06
2019
revised:
05
08
2019
accepted:
12
08
2019
pubmed:
27
8
2019
medline:
17
3
2021
entrez:
27
8
2019
Statut:
ppublish
Résumé
Muscle wasting and alterations of body composition are linked to clinical outcomes in numerous medical conditions. The role of myosteatosis in posttransplant outcomes remains to be determined. Here we investigated skeletal muscle mass and myosteatosis as prognostic factors in patients undergoing orthotopic liver transplantation (OLT). The data of 225 consecutive OLT recipients from a prospective database were retrospectively analyzed (May 2010-December 2017). Computed tomography-based skeletal-muscle-index (muscle mass), visceral-fat-area (visceral adiposity), and mean skeletal-muscle-radiation-attenuation (myosteatosis) were calculated using a segmentation tool. Cut-off values of myosteatosis resulted in a good stratification of patients into low- and high-risk groups in terms of morbidity (Clavien-Dindo ≥3b). Patients with myosteatosis had significantly higher complication rates (90-day Comprehensive Complication Index 68 ± 32 vs 44 ± 30, P < .001) and also displayed significantly longer intensive care (18 ± 25 vs 11 ± 21 days, P < .001) and hospital stay (56 ± 55 vs 33 ± 24 days, P < .001). Estimated costs were 44% higher compared to patients without myosteatosis. Multivariable analysis identified myosteatosis as an independent prognostic factor for major morbidity (odds ratio: 2.772, confidence interval: 1.516-5.066, P = .001). Adding myosteatosis to the well-established Balance-of-Risk-(BAR) score resulted in an increased prognostic value compared to the original BAR score. Myosteatosis may be a useful parameter to predict perioperative outcome in patients undergoing OLT, supporting the role of muscle quality (myosteatosis) over quantity (muscle mass) in this setting.
Identifiants
pubmed: 31448486
doi: 10.1111/ajt.15577
pii: S1600-6135(22)22201-1
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
493-503Informations de copyright
© 2019 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
Chen HW, Dunn MA. Arresting frailty and sarcopenia in cirrhosis: future prospects. Clin Liver Dis (Hoboken). 2018;11(2):52-57.
Montano-Loza AJ, Meza-Junco J, Baracos VE, et al. Severe muscle depletion predicts postoperative length of stay but is not associated with survival after liver transplantation. Liver Transpl. 2014;20(6):640-648.
Krell RW, Kaul DR, Martin AR, et al. Association between sarcopenia and the risk of serious infection among adults undergoing liver transplantation. Liver Transpl. 2013;19(12):1396-1402.
Reinders I, Murphy RA, Brouwer IA, et al. Muscle quality and myosteatosis: novel associations with mortality risk: the age, gene/environment susceptibility (AGES)-Reykjavik study. Am J Epidemiol. 2016;183(1):53-60.
van der Kroft G, Bours D, Janssen-Heijnen DM, van Berlo D, Konsten D. Value of sarcopenia assessed by computed tomography for the prediction of postoperative morbidity following oncological colorectal resection: a comparison with the malnutrition screening tool. Clin Nutr ESPEN. 2018;24:114-119.
Stretch C, Aubin JM, Mickiewicz B, et al. Sarcopenia and myosteatosis are accompanied by distinct biological profiles in patients with pancreatic and periampullary adenocarcinomas. PLoS ONE. 2018;13(5):e0196235.
Linder N, Schaudinn A, Langenhan K, et al. Power of computed-tomography-defined sarcopenia for prediction of morbidity after pancreaticoduodenectomy. BMC Med Imaging. 2019;19(1):32.
Dutkowski P, Oberkofler CE, Slankamenac K, et al. Are there better guidelines for allocation in liver transplantation? A novel score targeting justice and utility in the model for end-stage liver disease era. Ann Surg. 2011;254(5):745-753; discussion 753.
Feng S, Goodrich NP, Bragg-Gresham JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant. 2006;6(4):783-790.
Braat AE, Blok JJ, Putter H, et al. The Eurotransplant donor risk index in liver transplantation: ET-DRI. Am J Transplant. 2012;12(10):2789-2796.
Rana A, Jie T, Porubsky M, et al. The survival outcomes following liver transplantation (SOFT) score: validation with contemporaneous data and stratification of high-risk cohorts. Clin Transplant. 2013;27(4):627-632.
Rana A, Hardy MA, Halazun KJ, et al. Survival outcomes following liver transplantation (SOFT) score: a novel method to predict patient survival following liver transplantation. Am J Transplant. 2008;8(12):2537-2546.
Schlegel A, Linecker M, Kron P, et al. Risk assessment in high- and low-MELD liver transplantation. Am J Transplant. 2017;17(4):1050-1063.
Boecker J, Czigany Z, Bednarsch J, et al. Potential value and limitations of different clinical scoring systems in the assessment of short- and long-term outcome following orthotopic liver transplantation. PLoS ONE. 2019;14(3):e0214221.
Eslamparast T, Montano-Loza AJ, Raman M, Tandon P. Sarcopenic obesity in cirrhosis-the confluence of 2 prognostic titans. Liver Int. 2018;38(10):1706-1717.
EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol 2019;70(1):172-193.
Plauth M, Bernal W, Dasarathy S, et al. ESPEN guideline on clinical nutrition in liver disease. Clinical Nutrition (Edinburgh, Scotland). 2019;38(2):485-521.
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology (Baltimore, MD). 2018;67(1):328-357.
Nachit M, Leclercq IA. Emerging awareness on the importance of skeletal muscle in liver diseases: time to dig deeper into mechanisms!. Clin Sci. 2019;133(3):465-481.
Montano-Loza AJ, Angulo P, Meza-Junco J, et al. Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis. J Cachexia Sarcopenia Muscle. 2016;7(2):126-135.
Bhanji RA, Moctezuma-Velazquez C, Duarte-Rojo A, et al. Myosteatosis and sarcopenia are associated with hepatic encephalopathy in patients with cirrhosis. Hep Intl. 2018;12(4):377-386.
Bhanji RA, Takahashi N, Moynagh MR, et al. The evolution and impact of sarcopenia pre- and post-liver transplantation. Aliment Pharmacol Ther. 2019;49(6):807-813.
Englesbe MJ, Patel SP, He K, et al. Sarcopenia and mortality after liver transplantation. J Am Coll Surg. 2010;211(2):271-278.
Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012;30(9):1323-1341.
Ebadi M, Tandon P, Moctezuma-Velazquez C, et al. Low subcutaneous adiposity associates with higher mortality in female patients with cirrhosis. J Hepatol. 2018;69(3):608-616.
Schoening W, Helbig M, Buescher N, et al. Eurotransplant donor-risk-index and recipient factors: influence on long-term outcome after liver transplantation - A large single-center experience. Clin Transplant. 2016;30(5):508-517.
Zhang W, Park DJ, Lu B, et al. Epidermal growth factor receptor gene polymorphisms predict pelvic recurrence in patients with rectal cancer treated with chemoradiation. Clin Cancer Res. 2005;11(2 Pt 1):600-605.
Olthoff KM, Kulik L, Samstein B, et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl. 2010;16(8):943-949.
Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA. The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg. 2013;258(1):1-7.
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187-196.
Staiger RD, Cimino M, Javed A, et al. The Comprehensive Complication Index (CCI(R)) is a novel cost assessment tool for surgical procedures. Ann Surg. 2018;268(5):784-791.
Kelly DM, Bennett R, Brown N, et al. Predicting the discharge status after liver transplantation at a single center: a new approach for a new era. Liver Transpl. 2012;18(7):796-802.
Andert A, Becker N, Ulmer F, et al. Liver transplantation and donor body mass index >30: use or refuse? Ann Transplant. 2016;21:185-193.
Kienlein S, Schoening W, Andert A, Kroy D, Neumann UP, Schmeding M. Biliary complications in liver transplantation: impact of anastomotic technique and ischemic time on short- and long-term outcome. World J Transplant. 2015;5(4):300-309.
Hamaguchi Y, Kaido T, Okumura S, et al. Impact of quality as well as quantity of skeletal muscle on outcomes after liver transplantation. Liver Transpl. 2014;20(11):1413-1419.
Hamaguchi Y, Kaido T, Okumura S, et al. Proposal for new selection criteria considering pre-transplant muscularity and visceral adiposity in living donor liver transplantation. J Cachexia Sarcopenia Muscle. 2018;9(2):246-254.
Faitot F, Besch C, Battini S, et al. Impact of real-time metabolomics in liver transplantation: graft evaluation and donor-recipient matching. J Hepatol. 2018;68(4):699-706.
Agopian VG, Harlander-Locke MP, Markovic D, et al. Evaluation of early allograft function using the liver graft assessment following transplantation risk score model. JAMA Surg. 2018;153(5):436-444.
Thandassery RB, Montano-Loza AJ. Role of nutrition and muscle in cirrhosis. Curr Treat Options Gastroenterol. 2016;14(2):257-273.
Stephens NA, Skipworth RJ, Macdonald AJ, Greig CA, Ross JA, Fearon KC. Intramyocellular lipid droplets increase with progression of cachexia in cancer patients. J Cachexia Sarcopenia Muscle. 2011;2(2):111-117.
Hausman GJ, Basu U, Du M, Fernyhough-Culver M, Dodson MV. Intermuscular and intramuscular adipose tissues: bad vs good adipose tissues. Adipocyte. 2014;3(4):242-255.
van Dijk DPJ, Bakers FCH, Sanduleanu S, et al. Myosteatosis predicts survival after surgery for periampullary cancer: a novel method using MRI. HPB. 2018;20(8):715-720.