P- 34 TOMOGRAPHIC ASSESMENT OF SARCOPENIA IN CIRRHOTIC PATIENTS BEFORE LIVER TRASPLANT: PREVALENCE, ASSOCIATED FACTORS AND POST-SURGERY OUTCOMES IN A COHORT OF CHILEAN PATIENTS

Abstract

Introduction and Objectives

Sarcopenia is associated with worse outcomes in cirrhotic patients after liver transplant (LT). Recent studies have shown that tomographic assessment (TA) of sarcopenia is useful in cirrhosis. However, there is insufficient evidence regarding TA use in Latin American cirrhotic patients. This study aimed to describe the prevalence of sarcopenia by TA, associated factors, and outcomes in a cohort of patients undergoing LT.

Materials and Methods

Retrospective cohort of cirrhotic patients underwent LT (March 2015 - August 2021) with available abdominal CT up to 6 months before surgery. Baseline characteristics were obtained from clinical charts. A radiologist performed TA of sarcopenia through muscle area measurement of psoas (PMA), paravertebral (PVMA), paraspinal (PSMA), and its respective indexes, with defined sarcopenia cut-offs according to previous literature. Length hospital stay (LoS) after LT and 1-year mortality were recorded. Descriptive statistics and regression models were used to report sarcopenia TA and its association with baseline characteristics and outcomes after LT.

Results

During the study period, 163 patients underwent LT, 59 of them met inclusion criteria. Median time between TA and LT was 30 days (IQR 7-65). Mean age was 55±11 years, 51% females, 36% non-alcoholic steatohepatitis, 21% hepatocellular carcinoma, median MELD score of 23 (IQR: 17-28). Prevalence of sarcopenia assessed by any tomographic index was 72% (65% PMA, 56% PMI, and 37% PSMI). The baselines characteristics associated with sarcopenia were age (OR = 1.061, p-value=0.034) and sex (all sarcopenic were males). One-year mortality was 19% (22% in sarcopenic vs. 12% in non-sarcopenic patients, OR=1.969, p-value=0.423). LoS was 26 days (IQR 15-101), being longer in survivors with sarcopenia (IRR = 1.706, p-value<0.001).

Conclusions

Sarcopenia is frequent in cirrhotic patients underwent LT (72%), being associated with older age and male sex. While sarcopenia in TA does not significantly increase mortality, it does prolong LoS in LT survivors.