肝移植术前肌少症影响术后不良结局:单中心回顾性队列研究*

doi:10.3969/j.issn.1672-5069.2026.05.026

Abstract

Abstract: Objective The aim of this study was to investigate impact of preoperative sarcopenia on postoperative outcomes in patients with end-stage liver disease undergoing liver transplantation (LT). Methods A single-center retrospective cohort study was conducted, enrolling 321 adult patients who underwent allogeneic LT at Beijing You’an Hospital, Capital Medical University, between January 2015 and September 2022. The third lumbar skeletal muscle area (L3-SMA), third lumbar skeletal muscle index (L3-SMI) and skeletal muscle radiation attenuation (SM-RA) were measured by using abdominal CT scans and sarcopenia was diagnosed based on CT results. Binary Logistic regression analysis was applied to reveal risk factors. Results Of the 321 patients receiving LT, preoperative sarcopenia was found in 85 cases (26.5%); sarcopenia was more common in male than in female (29.2% vs. 14.0%,P＜0.01); elderly age, decreased BMI, concomitant liver cirrhosis and severe anemia were frequent in patients with sarcopenia (P＜0.01); L3-SMA, L3-SMI and SM-RA in patients with sarcopenia were (101.5±17.0)cm², (34.0±4.8)cm²/m² and (35.2±7.5)Hu, all much lower than [(136.2±25.0)cm², (46.6±7.1)cm²/m² and (38.9±6.7)Hu, respectively, P＜0.01] in those without sarcopenia; survival at 28 days in patients with sarcopenia was much lower than in those without (80.0% vs. 91.1%, P=0.006), and survival at one year was also significantly lower than in without(75.3% vs. 87.3%, P=0.008); binary Logistic regression analysis showed that sarcopenia, age, hepatic encephalopathy and end-stage liver disease-sodium (MELD-Na) score were all the independent risk factors for poor prognosis at day 28, and age and MELD-Na score were the independent risk factors for poor prognosis at one-year. Conclusion Preoperative sarcopenia could lead to poor short-term postoperative outcomes in patients undergoing LT, and CT-based assessment of L3-SMI and SM-RA could provide evidence for diagnosis of sarcopenia.

Key words: Liver transplantation, Sarcopenia, Third lumbar skeletal muscle index, Skeletal muscle radiation attenuation, Survival, Risk factors

Duan Xiaowan, Yu pengfei, Kong Ming, et al. Preoperative sarcopenia impacting postoperative short-term outcomes in recipients undergoing liver transplantation: A single-center retrospective cohort study[J]. Journal of Practical Hepatology, 2026, 29(5): 741-744.

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Preoperative sarcopenia impacting postoperative short-term outcomes in recipients undergoing liver transplantation: A single-center retrospective cohort study

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