Muscle depletion or
sarcopenia is associated with increased mortality in patients with
cirrhosis; how it affects mortality after
liver transplantation requires further study. In this study, we aimed to establish whether
sarcopenia predicts increased morbidity or mortality after
liver transplantation. We analyzed 248 patients with
cirrhosis who had a computed tomography (CT) scan including the third lumbar vertebra before
liver transplantation. Data were recovered from medical charts, the skeletal muscle cross-sectional area was measured with CT, and
sarcopenia was defined with previously published sex- and body mass index-specific cutoffs. One hundred sixty-nine patients (68%) were male, and the mean age at
transplantation was 55 ± 1 years. The etiologies of
cirrhosis were hepatitis C virus (51%), alcohol (19%), autoimmune
liver diseases (15%), hepatitis B virus (8%), and other etiologies (7%).
Sarcopenia was present in 112 patients (45%), and it was more frequent in males (P = 0.002), patients with
ascites (P = 0.02), and patients with higher
bilirubin levels (P = 0.05),
creatinine levels (P = 0.02), international normalized ratios (P = 0.04), Child-Pugh scores (P = 0.002), and Model for
End-Stage Liver Disease scores (P = 0.002). The median survival period after
liver transplantation was 117 ± 17 months for sarcopenic patients and 146 ± 20 months for nonsarcopenic patients (P = 0.4). Sarcopenic patients had longer
hospital stays (40 ± 4 versus 25 ± 3 days; P = 0.005) and a higher frequency of
bacterial infections within the first 90 days after
liver transplantation (26% versus 15%, P = 0.04) in comparison with nonsarcopenic patients. In conclusion,
sarcopenia is one of the most common complications in patients with
cirrhosis and is predictive of longer
hospital stays and a higher risk of perioperative
bacterial infections after
liver transplantation, but it is not associated with increased mortality.