Effects of sarcopenia on patients undergoing liver re-transplantation

Background: Loss of muscle mass (sarcopenia) has been found to be a measure of mortality after primary liver transplantation. We aimed to evaluate its effect in liver re-transplantation patients. Study Design: 67 liver re-transplant patients between 2005 and 2017 were evaluated. Relationship between psoas muscle index (PMI; total psoas muscle area at L3 level/height) with patient characteristics and lab values along with its effects on early and late mortality were assessed. Patient survival was compared using a log-rank test. Results: Median PMI was significantly different among males (878 cm2/m) and females (693 cm2/m) (p=0.045). Based on median PMI of each gender, patients were categorized into two groups (high and low PMI; M: n=21 & 19, F: n=15 & 12). MELD scores (P=0.24) along with lab values such as albumin (p=0.20), creatinine (p=0.95), total bilirubin (P=0.84) and INR (p=0.88) were similar in both low and high male PMI groups. Similar results were observed in the female PMI groups (p=0.33, p=0.87, p=0.56, p=0.40 and, p=0.36, respectively). Rates of mortality at 3, 6, and 12 months were similar in both sets of PMI groups (Male: p=0.92, p=0.92, and p=0.84; Female: p=0.46, p=0.73, and p=0.74, respectively). Hospital length of stay was also found to be similar both male (19 vs 24.5 days, p=0.85) and female groups (22 vs 14.5 days, p=0.29). Conclusion: Sarcopenia did not correlate with post-transplant outcomes or mortality after liver re-transplantation