Dorsal muscle group area and surgical outcomes in liver transplantation

Authors

  • Christopher S. Lee,

    Corresponding author
    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
    • Corresponding author: Christopher S. Lee, 823 E Summerfield Glen CIR, Ann Arbor, MI, 48176, USA.

      Tel.: +734 660 1504

      Fax: 734-936-5725

      e-mail: cleeho@med.umich.edu

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  • David C. Cron,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Michael N. Terjimanian,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Leah D. Canvasser,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Alyssa A. Mazurek,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Ellen Vonfoerster,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Lindsay M. Tishberg,

    1. School of Medicine, Tufts University, Medford, MA, USA
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  • Patrick W. Underwood,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Eric T. Chang,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Stewart C. Wang,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Christopher J. Sonnenday,

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Michael J. Englesbe

    1. Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA
    2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Conflict of interest: None.

Abstract

Introduction

Better measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes.

Methods

Our study population included liver transplant recipients with a preoperative CT scan. Cross-sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one- and five-yr mortality and one-yr complications. The relationship between dorsal muscle group area and post-transplantation outcome was assessed using univariate and multivariate techniques.

Results

Dorsal muscle group area measurements were strongly associated with psoas area (r = 0.72; p < 0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one-yr mortality (odds ratio [OR] = 0.53, p = 0.001), five-yr mortality (OR = 0.53, p < 0.001), and one-yr complications (OR = 0.67, p = 0.007).

Conclusion

Larger dorsal muscle group muscle size is associated with improved post-transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.

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