{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:21:18Z","timestamp":1790443278038,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T00:00:00Z","timestamp":1518825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The significance of pre\u2010operative body composition has recently attracted much attention in various diseases. However, cut\u2010off values for these parameters remain undetermined, and these factors are not currently included in selection criteria for recipients of living donor liver transplantation (LDLT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using computed tomography of 657 donors for LDLT, skeletal muscle mass, muscle quality, and visceral adiposity were evaluated by using skeletal muscle mass index (SMI), intramuscular adipose tissue content (IMAC), and visceral\u2010to\u2010subcutaneous adipose tissue area ratio (VSR). Sex\u2010specific cut\u2010offs for SMI, IMAC, and VSR were determined, and correlations with outcomes after LDLT in 277 recipients were examined with the aim of establishing new selection criteria for LDLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On the basis of younger donor data, we determined sex\u2010specific cut\u2010off values for low SMI, high IMAC, and high VSR (mean\u00a0\u00b1\u00a02 standard deviations). Patients with all three factors showed the lowest survival rate after LDLT (1\u00a0year survival rate, 41.2%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). On multivariate analysis, low SMI (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), high IMAC (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), and high VSR (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) were identified as independent risk factors for mortality after LDLT. Based on these findings, we have excluded patients showing all three factors (low SMI, high IMAC, and high VSR) as candidates for LDLT since October 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using cut\u2010off values determined from healthy donors, we have established new selection criteria for LDLT including body composition, which should improve post\u2010transplant outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12276","type":"journal-article","created":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T05:08:47Z","timestamp":1518844127000},"page":"246-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Proposal for new selection criteria considering pre\u2010transplant muscularity and visceral adiposity in living donor liver transplantation"],"prefix":"10.1002","volume":"9","author":[{"given":"Yuhei","family":"Hamaguchi","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimi","family":"Kaido","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine Kyoto University  Kyoto 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