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Background and aim <p>Sarcopenia, marked by muscle loss and weakness, is common in cirrhotic patients undergoing liver transplantation and is associated with poor postoperative outcomes. This study aimed to evaluate the impact of pre-transplant sarcopenia, assessed through handgrip strength (HGS), skeletal muscle indices (SMIs), bioelectrical impedance analysis (BIA), and the 6-min walk test (6MWT), on post-transplant mortality and hospital length of stay (LOS).</p> Methods <p>This retrospective cohort study was conducted on 127 cirrhotic patients who underwent liver transplantation between 2022 and 2023. Pre-transplant assessments included 6MWT, BIA, HGS, and SMI, and their associations with post-transplant outcomes, including LOS and mortality, were analyzed using Cox and linear regression models.</p> Results <p>In the fully adjusted model, a 6-min walk distance (6MWD) greater than 450 m was associated with a 76% reduction in the risk of mortality (HR = 0.24, <i>p</i>-trend = 0.049). Higher lean body mass to fat mass (LBM/FM) and stronger HGS were linked to reduced mortality (HR = 0.33, 95% CI 0.1–0.99 and HR = 0.17, 95% CI 0.04–0.73, respectively). SMI at T12 and L3 levels was associated with shorter LOS (<i>p</i> = 0.047 and <i>p</i> = 0.035, respectively).</p> Conclusion <p>Pre-transplant muscle function and quality were linked to post-transplant outcomes. Higher LBM/FM and stronger HGS were associated with lower mortality, while higher T12 and L3 SMIs correlated with shorter hospital stays, emphasizing the importance of muscle assessments in pre-transplant evaluations. Our data indicate that sarcopenia is a strong predictor of liver transplant prognosis; management of sarcopenia before liver transplantation may reduce mortality.</p>

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Pre-transplant physical performance, muscle quality, and body composition as predictors of post-liver transplant outcomes: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月13日

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  • Danial Fotros,
  • Ghazaleh Mahdavi-Mazdeh,
  • Zahra Yari,
  • Hanieh Sakhdari,
  • Reyhaneh Shojaei Asrami,
  • Pooneh Dehghan,
  • Hesameddin Eghlimi,
  • Amirhassan Rabbani,
  • Mahmoud Amiri,
  • Azita Hekmatdoost

摘要

Background and aim

Sarcopenia, marked by muscle loss and weakness, is common in cirrhotic patients undergoing liver transplantation and is associated with poor postoperative outcomes. This study aimed to evaluate the impact of pre-transplant sarcopenia, assessed through handgrip strength (HGS), skeletal muscle indices (SMIs), bioelectrical impedance analysis (BIA), and the 6-min walk test (6MWT), on post-transplant mortality and hospital length of stay (LOS).

Methods

This retrospective cohort study was conducted on 127 cirrhotic patients who underwent liver transplantation between 2022 and 2023. Pre-transplant assessments included 6MWT, BIA, HGS, and SMI, and their associations with post-transplant outcomes, including LOS and mortality, were analyzed using Cox and linear regression models.

Results

In the fully adjusted model, a 6-min walk distance (6MWD) greater than 450 m was associated with a 76% reduction in the risk of mortality (HR = 0.24, p-trend = 0.049). Higher lean body mass to fat mass (LBM/FM) and stronger HGS were linked to reduced mortality (HR = 0.33, 95% CI 0.1–0.99 and HR = 0.17, 95% CI 0.04–0.73, respectively). SMI at T12 and L3 levels was associated with shorter LOS (p = 0.047 and p = 0.035, respectively).

Conclusion

Pre-transplant muscle function and quality were linked to post-transplant outcomes. Higher LBM/FM and stronger HGS were associated with lower mortality, while higher T12 and L3 SMIs correlated with shorter hospital stays, emphasizing the importance of muscle assessments in pre-transplant evaluations. Our data indicate that sarcopenia is a strong predictor of liver transplant prognosis; management of sarcopenia before liver transplantation may reduce mortality.