{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:25:26Z","timestamp":1791872726798,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"publisher","award":["23\/19"],"award-info":[{"award-number":["23\/19"]}],"id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"publisher","award":["136\/17"],"award-info":[{"award-number":["136\/17"]}],"id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Myosteatosis is associated with perioperative outcomes in orthotopic liver transplantation (OLT). Here, we investigated the effects of body composition and myosteatosis on long\u2010term graft and patient survival following OLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data from 225 consecutive OLT recipients from a prospective database were retrospectively analysed (May 2010 to December 2017). Computed tomography\u2010based lumbar skeletal muscle index (SMI) (muscle mass) and mean skeletal muscle radiation attenuation (SM\u2010RA) (myosteatosis) were calculated using a segmentation tool (3D Slicer). Patients with low skeletal muscle mass (low SMI) and myosteatosis (low SM\u2010RA) were identified using predefined and validated cut\u2010off values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean donor and recipient age was 55\u00a0\u00b1\u00a016 and 54\u00a0\u00b1\u00a012\u00a0years, respectively. Some 67% of the recipients were male. The probability of graft and patient survival was significantly lower in patients with myosteatosis compared with patients with higher SM\u2010RA values (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.011 and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001, respectively). Low skeletal muscle mass alone was not associated with graft and patient survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.273 and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.278, respectively). Dividing the cohort into quartiles, based on the values of SMI and SM\u2010RA, resulted in significant differences in patient but not in graft survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.011). Even though multivariable analysis identified low SM\u2010RA as an important prognostic marker (hazard ratio: 2.260, 95% confidence interval: 1.177\u20134.340, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.014), myosteatosis lost its significance when early mortality (90\u00a0days) was excluded from the final multivariable model. Patients with myosteatosis showed significantly higher all\u2010cause mortality and in particular higher rates of deaths due to respiratory and septic complication (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.022, and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.049, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preoperative myosteatosis may be an important prognostic marker in patients undergoing deceased donor liver transplantation. The prognostic value of myosteatosis seems to be particularly important in the early post\u2010operative phase. Validation in prospective clinical trials is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12669","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T06:46:01Z","timestamp":1612334761000},"page":"358-367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["The role of recipient myosteatosis in graft and patient survival after deceased donor liver transplantation"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0373-3210","authenticated-orcid":false,"given":"Zoltan","family":"Czigany","sequence":"first","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Kramp","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Lurje","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"},{"name":"Department of Hepatology and Gastroenterology, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"},{"name":"Department of Surgery, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Bednarsch","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven Arke","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom Florian","family":"Ulmer","sequence":"additional","affiliation":[{"name":"Department of Surgery and Transplantation University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Bruners","sequence":"additional","affiliation":[{"name":"Institute of Radiology University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel","family":"Strnad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III University Hospital RWTH Aachen  Aachen 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