Frequency of sarcopenia in liver transplant patients, the effect of sarcopenia on prognosis and course of sarcopenia in the post-liver transplant period

Objective: Sarcopenia, which is commonly seen in patients with liver cirrhosis, of the liver is associated with an increase in the rate of complications of cirrhosis and decreases the quality of life and survival. It adversely affects the prognosis after transplantation.In our study, it was aimed to determine the frequency of sarcopenia in patients with liver cirrhosis and to investigate its relationship with the complications of cirrhosis and the prognosis of the disease. Materials and Methods: The study included 163 patients between the ages of 18 and 65. They were followed up in the Organ Transplantation Center of Akdeniz University Hospital. Patients were diagnosed with cirrhosis of the liver between January 2016 and December 2020, had a computed tomography. Laboratory and imaging data were fully accessible and completed. According to L3-SMI data obtained from abdominal computed tomography (CT) examinations taken before and after transplantation, patients were divided into two groups as those with and without sarcopenia. Demographic, clinical and laboratory findings, complications of cirrhosis, prognosis, mortality, the relationship between the presence of sarcopenia before transplantation and post-transplant complications and the course of sarcopenia after transplantation were examined. Results: The prevalence of sarcopenia was 73.6% (120/163) according to L3-SMI calculated on abdominal CT scans of liver cirrhosis patients included in the study.It was observed that 77.9% (92/120) of the patients with sarcopenia were male.The prevalence of sarcopenia in male patients was found to be statistically significantly higher than in females (p: 0.04). The mean BMI of sarcopenic patients was statistically significantly lower than non-sarcopenic patients (median BMI values of 24.46 ± 3.53 and 30.43 ± 4.45, respectively, p<0.001). Sarcopenia detected in patients with cirrhosis undergoing liver transplantation; had no relationship with Child-Pugh and MELD scoring, labrotary findings and complications of cirrhosis such as ascites, encephalopathy, variceal bleeding and 87 hepatocellular carcinoma. No relationship was found between Sarcopenia was not also related to postransplant infections, duration of intensive care unit and hospitalization period and mortality. Conclusion: It has been shown that sarcopenia is present at a high rate in patients with liver cirrhosis, independent of body mass index. It has been determined that especially male patients are at risk for the development of sarcopenia. It has been shown that sarcopenia does not improve after transplantation, on the contrary, sarcopenia develops after transplantation in a significant proportion of patients who did not have sarcopenia before transplantation. Keywords: Cirrhosis, Sarcopenia, Liver transplantation