The role of CT-scan assessment of muscle mass in predicting postoperative surgical complications after renal transplantation

Int Urol Nephrol. 2022 Mar;54(3):517-523. doi: 10.1007/s11255-021-03089-x. Epub 2021 Dec 12.

Abstract

Purpose: Despite a high rate of undernutrition in renal transplantation recipients, prognostic value of sarcopenia remains unclear. We evaluated the relation between sarcopenia and post-operative outcomes after renal transplantation.

Methods: During 7 years, each patient who underwent renal transplantation was retrospectively included. Patients with no recent pre-operative CT-scan were excluded. Sarcopenia was evaluated by measuring the muscle surface area on CT-scan section passing through the third lumbar vertebra. Main outcomes were post-operative complications at 1 month and 1 year according to the Clavien-Dindo classification.

Results: Overall, 102 patients were included. One month of complication rate was 63.9%. At 1 year, 60.8% experienced at least one medical complication and 29.4% one surgical complication. At 1 year post transplantation, low muscle density on CT scan was a surgical complication risk factor (OR = 0.6, 95% CI = [0.3-0.9], p = 0.05). The area under the curve of a 1-year complication predictive model including muscle density was 0.64. We did not observe significant relationship between CT-scan sarcopenia indicator and 1-month post-transplantation complication.

Conclusion: Although no clear link between sarcopenia and complications was exhibited in our study, low CT-scan muscle density was associated with 1-year surgical complications. The role of muscle density and its relation with sarcopenia and post-transplantation outcomes should be further explored.

Keywords: (MeSH): renal transplantation; Complications; End-stage kidney failure; Sarcopenia.

MeSH terms

  • Adult
  • Aged, 80 and over
  • Female
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging*
  • Muscle, Skeletal / pathology*
  • Organ Size
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sarcopenia / complications*
  • Tomography, X-Ray Computed*