WITHDRAWN: Do skeletal muscle index and myosteatosis impact postoperative outcomes after liver transplantation?

Abstract

• Skeletal muscle loss and myosteatosis is a frequent complication in patients with chronic or end-stage liver disease • The etiology of malnutrition in patients with chronic or end-stage liver disease is multifactorial. • Computed tomography (CT) with automated or semiautomated body composition analysis at the third lumbar vertebra has emerged as an objective method of defining the nutritional status of patients with chronic liver disease. • Nutritional status of a liver recipient is important, however due to complexity of liver transplant treatment not crucial. • Standardization and uniformity in definitions, methods, and cut-off points are crucial to producing reliable data in the future . Liver transplantation offers curative treatment to patients with acute liver failure and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes after liver transplantation. : Data of 138 adult patient patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in CT scan at the third lumbar vertebra level were calculated, and groups with and without low muscle mass and myosteatosis were compared for the length of ICU and hospitalization, postoperative complications, infection, and graft rejection. : In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer ICU stay ( P <0.025). Low SMI had no influence on ICU stay in female patients ( P =0.544) and length of hospitalisation (male, P >0.05; female, P =0,843). The presence of MI did not influence ICU stay ( P =0.161) or hospitalization ( P =0.771). Combining SMI and MI as predictive factors of poor outcome after liver transplantation had no influence on postoperative complication rates (males, P =0,883; females, P =0.113; both groups, P =0.839) and infection rate (males, P =0.293, females, P =0.285, both groups, P = 0.703). Graft rejection was not influenced by low SMI (males, P =0.875; females, P =0.135) and MI ( P =0.449). : In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation in patients with end-stage liver disease. Standardization and uniformly accepted definitions, methods, and cut-off points are crucial to producing reliable data in the future.