ESPEN 2013 - Abstract Submission
Liver and gastrointestinal tract
ESPEN13-1071
IMPACT OF SARCOPENIA AND PERIOPERATIVE NUTRITIONAL THERAPY ON SURVIVAL IN PATIENTS UNDERGOING LIVING DONOR LIVER TRANSPLANTATION
T. Kaido 1,*K. Ogawa 1Y. Fujimoto 1T. Ito 1K. Tomiyama 1A. Mori 1Y. Tamai 2N. Inagaki 3S. Uemoto 1
1Department of Hepato-Biliary-Pancreatic and Transplant Surgery, 2Nutrition Control Room, 3Diabetes and Clinical Nutrition, KYOTO UNIVERSITY, Kyoto, Japan
Rationale: Skeletal muscle depletion, referred to as sarcopenia, predicts morbidity and mortality in patients undergoing digestive surgery. However, the impact on liver transplantation is unclear. The present study investigated the impact of sarcopenia on patients undergoing living donor liver transplantation (LDLT).
Methods: Sarcopenia was assessed by a body composition analyzer (InBody 720) in 124 adult patients undergoing LDLT between February 2008 and April 2012. The correlation of sarcopenia with other patient factors (Spearman’s rank correlation coefficient), the impact of sarcopenia on survival after LDLT (log-rank test), and perioperative risk factors for poor survival (multivariate analysis using multiple logistic regression models) were analyzed.
Results: The median ratio of preoperative skeletal muscle mass was 92% (range 67%–130%) of the standard mass. Preoperative skeletal muscle mass was significantly correlated with the branched-chain amino acids to tyrosine ratio (r=-0.254, p=0.005) and body cell mass (r=0.636, p<0.001). The overall survival rate in patients with low skeletal muscle mass was significantly lower than in patients with normal/high skeletal muscle mass (p<0.001). Perioperative nutritional therapy significantly increased overall survival in patients with low skeletal muscle mass (p=0.009). Multivariate analysis showed that low skeletal muscle mass, low body cell mass, and lack of perioperative nutritional therapy were found to be risk factors for death after transplantation.
Conclusion: Sarcopenia was closely involved with post-transplant mortality in patients undergoing LDLT. Perioperative nutritional therapy significantly improved overall survival in patients with sarcopenia.
Disclosure of Interest: None Declared
Keywords: liver transplantationsarcopenia