Korean J Transplant.  2022 Nov;36(Supple 1):S302. 10.4285/ATW2022.F-4418.

Clinical impact of myosteatosis in liver transplant recipients

• Lee J
• Koh HH
• Min E
• Yim SH
• Choi M
• Kim DG
• Lee JG
• Joo DJ

• KMID: 2535529
• DOI: http://doi.org/10.4285/ATW2022.F-4418

Abstract

Background
Myosteatosis, excessive intramuscular fat disposition, is common in patients with chronic liver disease and is associated with increased morbidity and mortality. We investigated the effects of pretransplant myosteatosis on transplant outcomes following liver transplantation.
Methods
We analyzed 873 patients who underwent first liver transplantation between 2006 and 2019. Muscle quantity and quality were evaluated using the pretransplant computed tomography-based skeletal muscle index and intramuscular adiposity tissue contents (IMAC). Patients were grouped into myosteatosis and no myosteatosis group based on the sex-specific highest quartile of the IMAC.
Results
In total, mean laboratory model for end-stage liver disease (MELD) score was 23.2, 584 (66.9%) received a liver from a living donor, and 466 (53.4%) had hepatocellular carcinoma at the time of liver transplantation. During a median follow up of 65 months, 234 patients died and 14 underwent re-transplantation. The 1-year, 3-year, and 5-year patient survival rates were 80.1%, 71.3%, and 65.4% for the myosteatosis group and 89.7%, 82.5%, and 79.0% for the no myosteatosis group. Myosteatosis was associated with mortality (hazard ratio, 1.685; 95% confidence interval [CI], 1.282–2.215; P<0.001) and all-cause graft fail-ure (hazard ratio, 1.469; 95% CI, 1.112–1.940; P=0.007), independent of skeletal muscle index, visceral adiposity, MELD score, and donor characteristics. Myosteatosis was also associated with an increased risk of early allograft dysfunction (hazard ratio, 1.653; 95% CI, 1.081–2.527; P=0.020).
Conclusions
Pretransplant myosteatosis was associated with an increased risk of mortality and early allograft dysfunction after liver transplantation.