4.3 Article

Dorsal muscle group area and surgical outcomes in liver transplantation

Journal

CLINICAL TRANSPLANTATION
Volume 28, Issue 10, Pages 1092-1098

Publisher

WILEY
DOI: 10.1111/ctr.12422

Keywords

dorsal muscle group; end-stage liver disease; liver transplant; morphometric measure; psoas muscle; risk stratification; sarcopenia; surgical outcome

Funding

  1. NIH-NIDDK [K08 DK0827508]
  2. Blue Cross Blue Shield of Michigan Foundation

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IntroductionBetter measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes. MethodsOur study population included liver transplant recipients with a preoperative CT scan. Cross-sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one- and five-yr mortality and one-yr complications. The relationship between dorsal muscle group area and post-transplantation outcome was assessed using univariate and multivariate techniques. ResultsDorsal muscle group area measurements were strongly associated with psoas area (r=0.72; p<0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one-yr mortality (odds ratio [OR]=0.53, p=0.001), five-yr mortality (OR=0.53, p<0.001), and one-yr complications (OR=0.67, p=0.007). ConclusionLarger dorsal muscle group muscle size is associated with improved post-transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.

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