{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:50:53Z","timestamp":1783536653453,"version":"3.55.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum M\u00fcnster"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Imaging-based assessment of sarcopenia is a well-validated prognostic tool for patients with chronic liver disease. However, little is known about its value in patients with primary sclerosing cholangitis (PSC). This cross-sectional study aimed to investigate the predictive value of the cross-sectional imaging-based skeletal muscle index (SMI) for transplant-free survival (TFS) in patients with PSC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 95 patients with PSC who underwent abdominal cross-sectional imaging between 2008 and 2022 were included in this retrospective study. SMI was measured at the third lumbar vertebra level (L3-SMI). The cut-off values to define sarcopenia were &lt;\u200950\u00a0cm\u00b2\/m\u00b2 in male patients and &lt;\u200939\u00a0cm\u00b2\/m\u00b2 in female patients. The primary outcome of this study was TFS, which was defined as survival without liver transplantation or death from any cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our study indicates that L3-SMI sarcopenia impairs TFS in patients with PSC (5-year TFS: 33.9% vs. 83.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001, log-rank test). L3-SMI sarcopenia was independently associated with reduced TFS via multivariate Cox regression analysis (HR\u2009=\u20092.749;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). Body mass index reduction\u2009&gt;\u200910% at 12 months, which is used as MELD standard exception (SE) criterion in Eurotransplant (in Germany only until September 2023), was not significantly associated with TFS in the multivariate Cox regression analysis (HR\u2009=\u20091.417;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.330). Substitution of BMI reduction with L3-SMI in the German SE criteria improved the predictive accuracy of TFS compared to the established SE criteria (multivariable Cox regression analysis: HR\u2009=\u20094.007,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 vs. HR\u2009=\u20091.691,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.141).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Imaging-based diagnosis of sarcopenia via L3-SMI is associated with a low TFS in patients with PSC and may provide additional benefits as a prognostic factor in patient selection for liver transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-024-03232-9","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:01:44Z","timestamp":1714003304000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Imaging-based diagnosis of sarcopenia for transplant-free survival in primary sclerosing cholangitis"],"prefix":"10.1186","volume":"24","author":[{"given":"Pedram","family":"Keshoofi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Schindler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Rennebaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Cordes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haluk","family":"Morgul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Wildgruber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke S.","family":"Heinzow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Pascher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut H.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"H\u00fcsing-Kabar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Praktiknjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonel","family":"Trebicka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon Louis","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"issue":"2","key":"3232_CR1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1002\/ueg2.12204","volume":"10","author":"J Yu","year":"2022","unstructured":"Yu J, Refsum E, Helsingen LM, et al. 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The local institutional review board approved the study. Written informed consent of patients was waived by the Ethics Committee of the University of M\u00fcnster, Germany for retrospective data analysis. STROBE cohort reporting guidelines were used.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JT has received speaking and\/or consulting fees from Versantis, Gore, Boehringer-Ingelheim, Falk, Grifols, Genfit and CSL BehringLLS has received speaking fees from Gilead. Pedram Keshoofi, Florian Rennebaum, Philipp Schindler, Friederike Cordes, Haluk Morgul, Moritz Wildgruber, Hauke S. Heinzow, Andreas Pascher, Hartmut H. Schmidt, Anna H\u00fcsing-Kabar, Michael Praktiknjo, declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Preliminary selected data of this study have previously been presented at the Viszeralmedizin 2022 Conference of the German Society for Digestive and Metabolic Diseases (DGVS) in Hamburg and the United European Gastroenterology (UEG) Week 2022 in Vienna.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Presentation"}}],"article-number":"145"}}