ArticleEuropean journal of medical research2026
Pre-transplant physical performance, muscle quality, and body composition as predictors of post-liver transplant outcomes: a retrospective cohort study.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimSarcopenia, 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).
methodsThis 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.
resultsIn 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).
conclusionPre-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.
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