Impact of sarcopenic overweight on the outcomes after living donor liver transplantation
Impact of sarcopenic overweight on the outcomes after living donor liver transplantation
复制标题
DOI：
10.21037/hbsn.2017.02.02
复制
发表时间：
2017-12-01
影响因子：
8
通讯作者：
Uemoto, Shinji
中科院分区：
文献类型：
--
作者：
Hammad, Ahmed;Kaido, Toshimi;Uemoto, Shinji
背景：身体成分紊乱的影响最近受到关注。据报道，低肌肉质量和高体脂肪共同出现的肌源性肥胖预示着肝硬化患者的高死亡率。然而，相互作用的肌肉减少症和超重对肝移植后结局的影响尚不清楚。方法：我们评估了2008年1月至2013年11月在我院接受成人间活体肝移植的200例患者，根据入院时的BMI和腰大肌指数（PMI）分为4个亚组;肌肉减少性超重（SO）、肌肉减少性非超重（SN）、非肌肉减少性超重和非肌肉减少性非超重（NN）。比较四个亚组的短期结果和移植后总生存率。术前PMI较低的肌肉萎缩症患者术后菌血症和主要术后并发症的发生率较高，与PMI正常/较高的非肌肉萎缩症患者相比，移植后总体生存率较差（P= 25），术后菌血症的发生率在统计学上无差异，严重的术后并发症或移植后的总体存活率。与此相反，SN亚组（低PMI和BMI
Background: The effect of body composition disturbances has been recently in focus. Sarcopenic obesity, a co-occurrence of low muscle mass and high body fat was reportedly predictive of high mortality in patients with cirrhosis. However, the impact of the interacting sarcopenia and overweight on the outcomes after liver transplantation is still unclear.Methods: We evaluated 200 patients undergoing adult-to-adult living donor liver transplantation at our institution between January 2008 and November 2013 classified according to BMI and psoas muscle index (PMI) on admission to transplant into 4 subgroups; sarcopenic overweight (SO), sarcopenic non-overweight (SN), non-sarcopenic overweight and non-sarcopenic non-overweight (NN). Short-term outcomes and overall post-transplant survival were compared among the four subgroups.Results: Sarcopenic patients with preoperative low PMI had higher incidence of postoperative bacteremia and major postoperative complications, and poorer overall post-transplant survival than non-sarcopenic patients with normal/high PMI (P= 25) had statistically indifferent incidence of postoperative bacteremia, major postoperative complications or overall post-transplant survival than other recipients. In contrast, SN subgroup (low PMI and BMI