Donor Skeletal Muscle Quality Affects Graft Mortality After Living Donor Liver Transplantation- A Single Center, Retrospective Study

Abstract

The recipient muscle status is closely associated with postoperative poor survival in recipients of living donor liver transplantation (LDLT). However, it is uncertain whether LDLT donor muscle quality and quantity affect graft quality. Hence, we analyzed the correlation between donor muscle status and graft function. We measured the skeletal muscle mass index (SMI) and intramuscular adipose tissue content (IMAC) of 380 LDLT donors. We examined the correlation between donor SMI or IMAC and graft mortality, the occurrence rates of small-for-size graft (SFSG) syndrome, and 6-month graft survival rates. The donor SMI had no effect on the occurrence of SFSG syndrome and graft survival, while a high IMAC in both male and female donors was significantly correlated with the rate of SFSG syndrome [high vs low: (male donors) 15.8% vs. 2.5%, p = 0.0003; (female donors) 12.8% vs. 3.1%, p = 0.0234] and 6-month graft survival rates [(male donors) 87.7% vs 95.9%, p = 0.02; (female donors) 83.0% vs. 99.0%, p < 0.0001]. Multivariate analysis revealed that a high donor IMAC (HR; 5.42, CI; 2.13–13.8, p = 0.0004) was an independent risk factor for 6-month graft survival, and the donor IMAC is useful for donor selection for high-risk recipients.

Development of predictive score for postoperative dysphagia after emergency abdominal surgery in patients of advanced age

“…21 High IMAC reflects both increased intramuscular adipose tissue and loss of muscle mass and is associated with postoperative complications and poor outcomes. 22,23 Although the biological mechanisms underlying the relationship between IMAC and postoperative dysphagia are not yet known, IMAC is a crucial component of sarcopenia and can be easily measured by CT even in emergency situations.…”

“…However, the PMI may not reflect actual muscle mass because myosteatosis (skeletal muscle fat infiltration) increases with aging through leptin signaling, fibro‐adipogenic precursor cells, and mitochondrial dysfunction 21 . High IMAC reflects both increased intramuscular adipose tissue and loss of muscle mass and is associated with postoperative complications and poor outcomes 22,23 . Although the biological mechanisms underlying the relationship between IMAC and postoperative dysphagia are not yet known, IMAC is a crucial component of sarcopenia and can be easily measured by CT even in emergency situations.…”