TY - JOUR
T1 - Association between Abdominal CT Measurements of Body Composition before Deceased Donor Liver Transplant with Posttransplant Outcomes
AU - Shafaat, Omid
AU - Liu, Yi
AU - Jackson, Kyle R.
AU - Motter, Jennifer D.
AU - Boyarsky, Brian J.
AU - Latif, Muhammad A.
AU - Yuan, Frank
AU - Khalil, Adham
AU - King, Elizabeth A.
AU - Zaheer, Atif
AU - Summers, Ronald M.
AU - Segev, Dorry L.
AU - McAdams-DeMarco, Mara
AU - Weiss, Clifford R.
N1 - Publisher Copyright:
© RSNA, 2022.
PY - 2023/3
Y1 - 2023/3
N2 - Background: Pre–liver transplant (LT) sarcopenia is associated with poor survival. Methods exist for measuring body composition with use of CT scans; however, it is unclear which components best predict post-LT outcomes. Purpose: To quantify the association between abdominal CT–based body composition measurements and post-LT mortality in a large North American cohort. Materials and Methods: This was a retrospective cohort of adult first-time deceased-donor LT recipients from 2009 to 2018 who underwent pre-LT abdominal CT scans, including at the L3 vertebral level, at Johns Hopkins Hospital. Measurements included sarcopenia (skeletal muscle index [SMI] <50 in men and <39 in women), sarcopenic obesity, myosteatosis (skeletal muscle CT attenuation <41 mean HU for body mass index [BMI] <25 and <33 mean HU for BMI ≥25), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT ratio. Covariates in the adjusted models were selected with use of least absolute shrinkage and selection operator regression with lambda chosen by means of 10-fold cross-validation. Cox proportional hazards models were used to quantify associations with post-LT mortality. Model discrimination was quantified using the Harrell C-statistic. Results: A total of 454 recipients (median age, 57 years [IQR, 50–62 years]; 294 men) were evaluated. In the adjusted model, pre-LT sarcopenia was associated with a higher hazard ratio (HR) of post-LT mortality (HR, 1.6 [95% CI: 1.1, 2.4]; C-statistic, 0.64; P = .02). SMI was significantly negatively associated with survival after adjustment for covariates. There was no evidence that myosteatosis was associated with mortality (HR, 1.3 [95% CI: 0.86, 2.1]; C-statistic, 0.64; P = .21). There was no evidence that BMI (HR, 1.2 [95% CI: 0.95, 1.4]), VAT (HR, 1.0 [95% CI: 0.98, 1.1]), SAT (HR, 1.0 [95% CI: 0.97, 1.0]), and VAT/SAT rati (HR, 1.1 [95% CI: 0.90, 1.4]) were associated with mortality (P = .15–.77). Conclusions: Sarcopenia, as assessed on routine pre–liver transplant (LT) abdominal CT scans, was the only factor significantly associated with post-LT mortality.
AB - Background: Pre–liver transplant (LT) sarcopenia is associated with poor survival. Methods exist for measuring body composition with use of CT scans; however, it is unclear which components best predict post-LT outcomes. Purpose: To quantify the association between abdominal CT–based body composition measurements and post-LT mortality in a large North American cohort. Materials and Methods: This was a retrospective cohort of adult first-time deceased-donor LT recipients from 2009 to 2018 who underwent pre-LT abdominal CT scans, including at the L3 vertebral level, at Johns Hopkins Hospital. Measurements included sarcopenia (skeletal muscle index [SMI] <50 in men and <39 in women), sarcopenic obesity, myosteatosis (skeletal muscle CT attenuation <41 mean HU for body mass index [BMI] <25 and <33 mean HU for BMI ≥25), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT ratio. Covariates in the adjusted models were selected with use of least absolute shrinkage and selection operator regression with lambda chosen by means of 10-fold cross-validation. Cox proportional hazards models were used to quantify associations with post-LT mortality. Model discrimination was quantified using the Harrell C-statistic. Results: A total of 454 recipients (median age, 57 years [IQR, 50–62 years]; 294 men) were evaluated. In the adjusted model, pre-LT sarcopenia was associated with a higher hazard ratio (HR) of post-LT mortality (HR, 1.6 [95% CI: 1.1, 2.4]; C-statistic, 0.64; P = .02). SMI was significantly negatively associated with survival after adjustment for covariates. There was no evidence that myosteatosis was associated with mortality (HR, 1.3 [95% CI: 0.86, 2.1]; C-statistic, 0.64; P = .21). There was no evidence that BMI (HR, 1.2 [95% CI: 0.95, 1.4]), VAT (HR, 1.0 [95% CI: 0.98, 1.1]), SAT (HR, 1.0 [95% CI: 0.97, 1.0]), and VAT/SAT rati (HR, 1.1 [95% CI: 0.90, 1.4]) were associated with mortality (P = .15–.77). Conclusions: Sarcopenia, as assessed on routine pre–liver transplant (LT) abdominal CT scans, was the only factor significantly associated with post-LT mortality.
UR - http://www.scopus.com/inward/record.url?scp=85148480062&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85148480062&partnerID=8YFLogxK
U2 - 10.1148/radiol.212403
DO - 10.1148/radiol.212403
M3 - Article
C2 - 36283115
AN - SCOPUS:85148480062
SN - 0033-8419
VL - 306
JO - RADIOLOGY
JF - RADIOLOGY
IS - 3
M1 - e212403
ER -