Background: Patients with liver cirrhosis may experience loss of fat mass or fat-free mass due to various reasons related to the condition. One of the main reasons is the impaired metabolism of nutrients, especially proteins and fats. This can lead to a decrease in the synthesis of proteins necessary for maintaining muscle mass, as well as alterations in the way fats are processed and stored in the body. Also, patients may experience changes in body composition after liver transplantation due to several factors related to the surgery and post-transplant care such as immunosuppressive medication, post-surgical recovery, changes in diet and physical activity, and nutritional deficiencies. In this study, we aimed to assess the body composition of liver transplant recipients before and after transplantation surgery.
Methods: The body composition of liver transplant patients in two centers in Iran was assessed using the bioimpedance InBody S10 before, one, and three months after transplant surgery. Several indices including body mass index (BMI), fat mass, fat-free mass (FFM), skeletal muscle mass index (SMI), and visceral fat area were analyzed. SMI was calculated by dividing body skeletal muscle mass (kg) by the square of height (m²), and low muscle mass was defined as SMI of < 7 kg/m² in men and < 5.7 kg/m² in women.
Results: thirty-nine patients (59% men) with a mean age of 48.4 years were evaluated. The mean BMI was 24.1 kg/m². The results of the body composition assessment indicated that FFM (47.7±12 vs 43.8±10 (after 1 month) and 45.9±11 (after 3 months)) and SMI (7.8±2 vs 6.5±1 (after 1 month) and 6.8±1 (after 3 months)) significantly decreased after transplant surgery. However, the reduction of fat mass after surgery was not significant. Sarcopenia based on SMI was detected in 2.9%, 17.6%, and 13.3% of men and in 11.8%, 26.5%, and 20% of women before, one, and three months after surgery, respectively. Sarcopenia significantly increased one month after transplant surgery (P-value = 0.007).
Conclusions: Loss of muscle mass and sarcopenia is frequent after liver transplant surgery, especially in the first month, which indicates the importance of nutritional assessment and proper nutritional support post-liver transplant surgery to reducing the risk of sarcopenia, promoting muscle strength, and enhancing overall recovery post-surgery.