{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:51:12Z","timestamp":1777895472068,"version":"3.51.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Computed tomography (CT)\u2010derived body metrics such as skeletal muscle index (SMI), psoas muscle index (PMI), and subcutaneous fat area index (ScFI) are measurable components of sarcopenia, frailty, and nutrition. While these body metrics are advocated in adults for predicting postoperative outcomes after liver transplantation (LT), little is known about their value in pediatric populations. This study assessed the relation between preoperative CT\u2010based body metrics and postoperative short\u2010term outcomes in pediatric LT recipients. Patients aged 0\u201018\u00a0years who underwent a primary LT were retrospectively included (n\u00a0=\u00a0101; median age 0.5\u00a0years; range 0.2\u201017.1). SMI, PMI, and ScFI were derived from preoperative axial CT slices. Postoperative outcomes and complications within 90\u00a0days were correlated with the CT\u2010based body metrics. To classify postoperative infections, the Clavien\u2010Dindo (CD) classification was used. Subgroup analyses were performed for age groups (&lt;1, 1\u201010, and &gt;10\u00a0years old). An optimal threshold for test performance was defined using Youden\u2019s <jats:italic toggle=\"yes\">J<\/jats:italic>\u2010statistic and receiver operating characteristic curve as appropriate. ScFI was significantly (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001) correlated with moderate to severe postoperative infections (CD grade 3\u20105) in children aged &lt;1 year, with the optimal ScFI threshold being \u226427.1\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> (sensitivity 80.4% and specificity 77.8%). A weak negative correlation between SMI and the total duration of hospital stay (<jats:italic toggle=\"yes\">R<\/jats:italic>\u00a0=\u00a0\u22120.3; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01) and intensive care unit (ICU) stay (<jats:italic toggle=\"yes\">R<\/jats:italic>\u00a0=\u00a0\u22120.3; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01) was observed in children aged &lt;1 year. No other associations between CT\u2010based body metrics and postoperative outcomes were shown. In children aged &lt;1 year with cirrhotic liver disease undergoing LT, preoperative CT\u2010based body metrics were correlated with moderate to severe postoperative infections (ScFI) and with longer duration of hospital and ICU stay (SMI), and thus can be considered important tools for pre\u2010LT risk assessment.<\/jats:p>","DOI":"10.1002\/lt.26205","type":"journal-article","created":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T10:11:45Z","timestamp":1623492705000},"page":"1779-1787","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Utility of Preoperative Computed Tomography\u2013Based Body Metrics in Relation to Postoperative Complications in Pediatric Liver Transplantation Recipients"],"prefix":"10.1097","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-5781","authenticated-orcid":false,"given":"Martijn V.","family":"Verhagen","sequence":"first","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stef","family":"Levolger","sequence":"additional","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Binne","family":"Hulshoff","sequence":"additional","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-0286","authenticated-orcid":false,"given":"Maureen J. M.","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert P. J.","family":"van der Doef","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain R.","family":"Viddeleer","sequence":"additional","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben H.","family":"de Kleine","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robbert J.","family":"de Haas","sequence":"additional","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"lt26205-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1053\/j.sempedsurg.2017.07.014","article-title":"Pediatric liver transplantation","volume":"26","year":"2017","journal-title":"Semin Pediatr Surg"},{"key":"lt26205-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/jpen.1414","article-title":"Persistence of sarcopenia after pediatric liver transplantation is associated with poorer growth and recurrent hospital admissions","volume":"43","year":"2019","journal-title":"J Parenter Enteral Nutr"},{"key":"lt26205-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/MPG.0000000000001651","article-title":"Severe sarcopenia and increased fat stores in pediatric patients with liver, kidney, or intestine 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History"}},{"value":"2021-06-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}