The Effects of Sarcopenia on Postoperative Outcomes in Living Donor Liver Transplantation Recipients: Insights From a Turkish Single-Center Study.

BACKGROUND: Sarcopenia, characterized by loss of muscle mass and strength, is a common condition in patients with cirrhosis and can influence outcomes after liver transplantation. This study aimed to compare the effects of sarcopenia on postoperative bacteremia, complications, and survival rates in living donor liver transplantation (LDLT) recipients in the Turkish population. METHODS: We conducted a retrospective analysis of 65 adult LDLT recipients from May 2021 to May 2023. Sarcopenia was diagnosed using preoperative abdominal CT by assessing psoas muscle area and psoas muscle index. Recipients were categorized into sarcopenic (Group 1) and nonsarcopenic (Group 2) groups. Demographic data, comorbidities, postoperative complications, and survival rates were analyzed. Statistical analyses included univariate and multivariate Cox regression for survival. RESULTS: The prevalence of sarcopenia was 55%. Major complications occurred in 44% of sarcopenic and 14% of nonsarcopenic recipients (P = .008). The 30-day and 3-month survival rates were significantly lower in sarcopenic recipients (83% versus 100%, P = .023). Although 1-year and overall survival rates showed no significant difference, sarcopenic recipients demonstrated a trend toward lower survival rates. Multivariate analysis revealed that sarcopenia and hypertension significantly impacted overall survival. CONCLUSIONS: Sarcopenia was associated with increased postoperative complications and a tendency for lower short-term survival in LDLT recipients. The findings underscore the clinical importance of early detection and management of sarcopenia in improving outcomes for liver transplant candidates. This study highlights the multifactorial nature of mortality risk in liver transplant recipients, with sarcopenia playing a crucial role.