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Publications

Journal Article Epublish

PubMed: 39318868 DOI: 10.1002/jgh3.70024

Liver transplant recipients have worse metabolic body phenotype compared with matched non-transplant controls.

JGH Open 8(9):e70024

Authors: Chandra Bhati, Danielle Kirkman, Mikael F Forsgren, Hiba Kamal, Hiba Khan, Sherry Boyett, Olof Dahlqvist Leinhard, Jennifer Linge, Vaishali Patel, Samarth Patel, Susan Wolver, Mohammad S Siddiqui

Affiliations

  • Division of Transplant Surgery University of Maryland Baltimore Maryland USA.
  • Department of Kinesiology and Health Sciences Virginia Commonwealth University (VCU) Richmond Virginia USA.
  • AMRA Medical AB Linköping Sweden.
  • Center for Medical Image Science and Visualization and Department of Health, Medicine and Caring Sciences Linkoping University Linköping Sweden.
  • Division of Gastroenterology and Hepatology VCU Richmond Virginia USA.
  • Virginia Commonwealth University Richmond Virginia USA.
  • Department of Internal Medicine VCU Richmond Virginia USA.
  • University of Pennsylvania Philadelphia Pennsylvania USA.

Abstract

Background and Aim

Quantification of body compartments, particularly the interaction between adipose tissue and skeletal muscle, is emerging as novel a biomarker of metabolic health. The present study evaluated the impact of liver transplant (LT) on body compartments.

Methods

Totally 66 adult LT recipients were enrolled in whom body compartments including visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), muscle fat infiltration (MFI), fat-free muscle volume (FFMV), and liver fat (LF) were quantified via whole body magnetic resonance imaging (MRI). To provide non-LT comparison, each LT recipient was matched to at least 150 non-LT controls for same sex, age, and body mass index (BMI) from the UK Biobank registry.

Results

LT recipients ( matched non-LT controls) had significantly higher subcutaneous (13.82 ± 5.47 12.10 ± 5.10 L,  < 0.001) and visceral fat (7.59 ± 3.75 6.72 ± 3.06 L,  = 0.003) and lower LF (5.88 ± 7.14 8.75 ± 6.50%,  < 0.001) and muscle volume (11.69 ± 2.95 12.12 ± 2.90 L,  = 0.027). In subgroup analysis, patients transplanted for metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis ( non-MASH cirrhosis) had higher ASAT, VAT, and MFI. A trend toward higher LF content was noted; however, this did not reach statistical significance (6.90 ± 7.35 4.04 ± 6.23%,  = 0.189). Finally, compared with matched non-LT controls, patients transplanted for MASH cirrhosis had higher ASAT and VAT; however, FFMV and MFI were similar.

Conclusion

Using non-LT controls, the current study established the higher-than-expected adiposity burden among LT recipients, which is even higher among patients transplanted for MASH cirrhosis. These findings provide data needed to design future studies developing radiomics-based risk-stratification strategies in LT recipients.

MeSH

Liver Transplantation, Muscles, Non-Alcoholic Fatty Liver Disease, Phenotype, Body Composition, Liver, Transplants, Muscle, Skeletal, Tissues, Adipose Tissue