Impacto da Sarcopenia no Desenvolvimento de Complicações Biliares Tardias após Transplante Hepático ; Impact of Sarcopenia on the Development of Late Biliary Complications after Liver Transplantation

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina ; Background and Aim: Up to about 70% of cirrhotic patients have sarcopenia, known as a progressive loss of muscle mass and frequent complication in the evolution of End-stage Liver Disease (DHT). Its quantitative evaluation can be done through computed tomography (TC), by estimating the total area of the psoas muscle (PMA) in axial sections at the third lumbar vertebra (L3) level. Sarcopenia reflects the patient’s nutrition status, leading to worst clinical perioperative prognosis and higher morbimortality after liver transplant (TH). Besides that, between 10-40% of patients manifest postoperative biliary complications (CB), jeopardizing the long-term success and the graft survival, aggravating clinical situation of patients and the need for invasive procedures in hospital environment. Therefore, we intend to assess the existence of a correlation between sarcopenia in patients with DHT undergoing TH, with the appearance of late post-transplant CB.Methods: All patients that underwent TH in Liver Transplantation Unit (UTH) from Coimbra Hospital and Universitary Centre (CHUC), between 1 January 2013 and 31 December 2017, were retrospectively evaluated after applying inclusion and exclusion criteria. The selection of pre, intra and postoperative parameters from the recipient, donor, surgical procedure, and corresponding graft, allowed to characterize and submit the studied population to statistical treatment. The definitions of CB, follow-up times and ischemia times were established and described, as well as the determination of the existence of sarcopenia based on reference cutoff values, in PMA calculation and in the TC performed in the pre-TH study. This way, 4 groups of patients were obtained: sarcopenic patients (DS) versus non-sarcopenic patients (DNS) and patients with CB versus without CB patients).Results: The sample included 68 patients, of whom the majority (86,8%; n=59) were male, with a mean age of 56,6 ± 10,7 years ...