Bone Mineral Density Predicts Post-transplant Survival among Hepatocellular Carcinoma Liver Transplant Recipients
Hepatocellular carcinoma (HCC) is a common indication for liver transplantation (LT). Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of body composition on post-LT mortality in patients with HCC. Methods: Data on adult LT recipients who r...
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| Veröffentlicht in: | Liver transplantation 2016-06, Vol.22 (8), p.1092-1098 |
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| container_title | Liver transplantation |
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| creator | Sharma, Pratima Parikh, Neehar D Yu, Jessica Barman, Pranab Derstine, Brian A Sonnenday, Christopher J Wang, Stewart C Su, Grace L |
| description | Hepatocellular carcinoma (HCC) is a common indication for liver transplantation (LT). Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of body composition on post-LT mortality in patients with HCC. Methods: Data on adult LT recipients who received MELD exception for HCC between 2/29/02-12/31/13 and had CT scan anytime 6 months prior to LT were reviewed (N=118). All available CT scan DICOM (Digital Imaging and Communications in Medicine) files were analyzed using a semiautomated high throughput methodology with algorithms programmed in MATLAB®. Analytic morphomics measurements including dorsal muscle group (DMG) area, visceral and subcutaneous fat and bone mineral density (BMD) were taken at the bottom of the 11th thoracic vertebral level. Results: Thirty-two patients (28%) died during the median follow up of 4.4 years. Number of HCC lesions (HR=2.72; P |
| doi_str_mv | 10.1002/lt.24458 |
| format | Article |
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Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of body composition on post-LT mortality in patients with HCC. Methods: Data on adult LT recipients who received MELD exception for HCC between 2/29/02-12/31/13 and had CT scan anytime 6 months prior to LT were reviewed (N=118). All available CT scan DICOM (Digital Imaging and Communications in Medicine) files were analyzed using a semiautomated high throughput methodology with algorithms programmed in MATLAB®. Analytic morphomics measurements including dorsal muscle group (DMG) area, visceral and subcutaneous fat and bone mineral density (BMD) were taken at the bottom of the 11th thoracic vertebral level. Results: Thirty-two patients (28%) died during the median follow up of 4.4 years. Number of HCC lesions (HR=2.72; P<0.001), BMD (HR=0.90/HU; P=0.03), pre-LT loco-regional therapy (HR=0.34; P<0.001) and donor age (HR=1.05; P<0.001) were the independent predictors of post-LT mortality. DMG area did not affect post-LT survival. Conclusion: In addition to number of HCC lesions and pre-LT loco-regional therapy, low BMD, a surrogate for bone loss rather than DMG area, was independently associated with post-LT mortality in HCC patients. Bone loss may be an early marker of deconditioning that precedes sarcopenia and may affect transplant outcomes.</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.24458</identifier><identifier>PMID: 27064263</identifier><language>eng</language><ispartof>Liver transplantation, 2016-06, Vol.22 (8), p.1092-1098</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids></links><search><creatorcontrib>Sharma, Pratima</creatorcontrib><creatorcontrib>Parikh, Neehar D</creatorcontrib><creatorcontrib>Yu, Jessica</creatorcontrib><creatorcontrib>Barman, Pranab</creatorcontrib><creatorcontrib>Derstine, Brian A</creatorcontrib><creatorcontrib>Sonnenday, Christopher J</creatorcontrib><creatorcontrib>Wang, Stewart C</creatorcontrib><creatorcontrib>Su, Grace L</creatorcontrib><title>Bone Mineral Density Predicts Post-transplant Survival among Hepatocellular Carcinoma Liver Transplant Recipients</title><title>Liver transplantation</title><description>Hepatocellular carcinoma (HCC) is a common indication for liver transplantation (LT). Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of body composition on post-LT mortality in patients with HCC. Methods: Data on adult LT recipients who received MELD exception for HCC between 2/29/02-12/31/13 and had CT scan anytime 6 months prior to LT were reviewed (N=118). All available CT scan DICOM (Digital Imaging and Communications in Medicine) files were analyzed using a semiautomated high throughput methodology with algorithms programmed in MATLAB®. Analytic morphomics measurements including dorsal muscle group (DMG) area, visceral and subcutaneous fat and bone mineral density (BMD) were taken at the bottom of the 11th thoracic vertebral level. Results: Thirty-two patients (28%) died during the median follow up of 4.4 years. Number of HCC lesions (HR=2.72; P<0.001), BMD (HR=0.90/HU; P=0.03), pre-LT loco-regional therapy (HR=0.34; P<0.001) and donor age (HR=1.05; P<0.001) were the independent predictors of post-LT mortality. DMG area did not affect post-LT survival. Conclusion: In addition to number of HCC lesions and pre-LT loco-regional therapy, low BMD, a surrogate for bone loss rather than DMG area, was independently associated with post-LT mortality in HCC patients. Bone loss may be an early marker of deconditioning that precedes sarcopenia and may affect transplant outcomes.</description><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqlT81KAzEYDKLYVgUfIS-wNdlNdu3Fg9XSg0KpvYfP9LN-kk3WJLvQt3cPonj2NAPzwwxj11LMpRDljcvzUil9e8KmUpdNUaumOv3htZ6wWUofQkipF-KcTcpG1Kqsqyn7vA8e-TN5jOD4A_pE-cg3Efdkc-KbkHKRI_jUOfCZv_RxoGF0Qhv8ga-xgxwsOtc7iHwJ0ZIPLfAnGjDy3W9wi5Y6Qp_TJTt7A5fw6hsv2N3qcbdcF13_2uLejp5xiukitRCPJgCZv4qnd3MIg1GLejyoq38XfAEjIGn3</recordid><startdate>20160629</startdate><enddate>20160629</enddate><creator>Sharma, Pratima</creator><creator>Parikh, Neehar D</creator><creator>Yu, Jessica</creator><creator>Barman, Pranab</creator><creator>Derstine, Brian A</creator><creator>Sonnenday, Christopher J</creator><creator>Wang, Stewart C</creator><creator>Su, Grace L</creator><scope>5PM</scope></search><sort><creationdate>20160629</creationdate><title>Bone Mineral Density Predicts Post-transplant Survival among Hepatocellular Carcinoma Liver Transplant Recipients</title><author>Sharma, Pratima ; Parikh, Neehar D ; Yu, Jessica ; Barman, Pranab ; Derstine, Brian A ; Sonnenday, Christopher J ; Wang, Stewart C ; Su, Grace L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmedcentral_primary_oai_pubmedcentral_nih_gov_49615253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sharma, Pratima</creatorcontrib><creatorcontrib>Parikh, Neehar D</creatorcontrib><creatorcontrib>Yu, Jessica</creatorcontrib><creatorcontrib>Barman, Pranab</creatorcontrib><creatorcontrib>Derstine, Brian A</creatorcontrib><creatorcontrib>Sonnenday, Christopher J</creatorcontrib><creatorcontrib>Wang, Stewart C</creatorcontrib><creatorcontrib>Su, Grace L</creatorcontrib><collection>PubMed Central (Full Participant titles)</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sharma, Pratima</au><au>Parikh, Neehar D</au><au>Yu, Jessica</au><au>Barman, Pranab</au><au>Derstine, Brian A</au><au>Sonnenday, Christopher J</au><au>Wang, Stewart C</au><au>Su, Grace L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bone Mineral Density Predicts Post-transplant Survival among Hepatocellular Carcinoma Liver Transplant Recipients</atitle><jtitle>Liver transplantation</jtitle><date>2016-06-29</date><risdate>2016</risdate><volume>22</volume><issue>8</issue><spage>1092</spage><epage>1098</epage><pages>1092-1098</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><abstract>Hepatocellular carcinoma (HCC) is a common indication for liver transplantation (LT). Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of body composition on post-LT mortality in patients with HCC. Methods: Data on adult LT recipients who received MELD exception for HCC between 2/29/02-12/31/13 and had CT scan anytime 6 months prior to LT were reviewed (N=118). All available CT scan DICOM (Digital Imaging and Communications in Medicine) files were analyzed using a semiautomated high throughput methodology with algorithms programmed in MATLAB®. Analytic morphomics measurements including dorsal muscle group (DMG) area, visceral and subcutaneous fat and bone mineral density (BMD) were taken at the bottom of the 11th thoracic vertebral level. Results: Thirty-two patients (28%) died during the median follow up of 4.4 years. Number of HCC lesions (HR=2.72; P<0.001), BMD (HR=0.90/HU; P=0.03), pre-LT loco-regional therapy (HR=0.34; P<0.001) and donor age (HR=1.05; P<0.001) were the independent predictors of post-LT mortality. DMG area did not affect post-LT survival. Conclusion: In addition to number of HCC lesions and pre-LT loco-regional therapy, low BMD, a surrogate for bone loss rather than DMG area, was independently associated with post-LT mortality in HCC patients. Bone loss may be an early marker of deconditioning that precedes sarcopenia and may affect transplant outcomes.</abstract><pmid>27064263</pmid><doi>10.1002/lt.24458</doi></addata></record> |
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| title | Bone Mineral Density Predicts Post-transplant Survival among Hepatocellular Carcinoma Liver Transplant Recipients |
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