Effect of pre-transplant sarcopenia on the estimation of standard liver volume in living-donor liver transplant candidates: risk factor for post-transplant small-for-size syndrome? A retrospective study.
living-donor liver transplantation
sarcopenia
skeletal muscle mass index
small-for-size syndrome
standard liver volume
thoracic width
Journal
Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
24
02
2020
revised:
30
03
2020
accepted:
29
06
2020
pubmed:
6
7
2020
medline:
25
6
2021
entrez:
5
7
2020
Statut:
ppublish
Résumé
The aim of the present study was to investigate whether LT candidates with sarcopenia are at an increased risk of receiving an inappropriate standard liver volume (SLV) estimation by standard body weight (BW)-derived SLV formula. Non-BW-SLV estimation formulas were tested in 262 LDLT donors and compared to a standard BW-SLV formula. The anthropometric parameters used were the thoracic width (TW-SLV) and thoracoabdominal circumference (TAC-SLV). Subsequently, sarcopenic and non-sarcopenic LDLT candidates (total, 217 patients) were compared in terms of estimated BW-SLV (routine method) and non-BW-SLV. In donors, TW-SLV showed comparable concordance with CT scan measured total liver volume as BW-SLV. The performance of TAC-SLV was low. In recipients, the prevalence of pre-LT sarcopenia was 30.4%. Sarcopenic patients were attributed a significantly lower BW-SLV than non-sarcopenic (sarcopenia vs no-sarcopenia, 1063.8 ml [1004.1-1118.4] vs. 1220.7 ml [1115.0-1306.6], P < 0.001), despite comparable TW-SLV, age, body height, and gender prevalence. As a result, sarcopenic patients received a graft with a statistically lower weight at organ procurement and developed more frequently a small-for-size syndrome (SFSS) according to the Dahm et al. (27.7% vs. 6.8%, P < 0.01) and Kyushu (28.7% vs. 9.2%, P < 0.01) definition. Therefore, In sarcopenic patients, BW-SLV formulas are affected by an high risk of SLV underestimation, thus exposing them to an increased risk of post-LT SFSS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1282-1290Informations de copyright
© 2020 Steunstichting ESOT. Published by John Wiley & Sons Ltd.
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