Retrospective analysis of the effect of sarcopenia on mortality and morbidity in liver transplant patients

Purpose: aim of this study is investigate the association between sarcopenia and the PMI and PNI indices with morbidity and mortality in cadaveric liver transplant patients in the postoperative period. Methods: The data of 52 patients who were operated on by General Surgery Department of Çukurova University Faculty of Medicine were retrospectively analysed. Results: Our study population 42 (80.8%) were male. The average age of the patients was 52.8 ± 10.6 (18 – 66) years and the average body mass indexes were 25.2 ± 3.8 kg/m2. The average overall survival time of the patients was 77.8 ± 9.5 months. The average overall survival time of the sarcopenic patients determined by the PMI was 62.2 ± 16.4 months, and that of the non-sarcopenic patients was 83.6 ± 11.4 months. Although there was a difference according to the presence of sarcopenia, no statistically significant difference was found (p = 0.370). Sarcopenia is more common in male, Child – Pugh category C, presence of ascites, ASA ≥ 3 patients, and Clavien – Dindo grade ≥ 3 patients. There was a significant relationship between sarcopenia and low BMI and albumin (p < 0.05). Sarcopenic patients are more common in the low PNI group than in the high PNI group. There is a significant statistical relationship between Child – Pugh score and PNI (p = 0.012). It was found that blood AFP and albumin levels were associated with low PNI (p = 0.007, p = 0.001). Conclusion: The average overall survival time of the patients was found to be shorter in the sarcopenic patients determined by the PMI. With this situation, it was found that the presence of sarcopenia is a negative prognostic factor on survival. An increase of 1 unit in PNI increases the 3-month mortality risk by 5.7%. An increase of 1 unit in PNI increases the overall mortality risk by 3.3%. In conclusion, it can be said that PNI has its place in the evaluation of sarcopenia and that there is a negative prognostic effect between sarcopenia and the clinical outcomes of liver transplant patients. The development of this study with prospective and multi-center studies will be useful in terms of the statistical stability of the results.