Impact of myosteatosis on outcomes after liver transplantation: a systematic review and meta-analysis

The impact of myosteatosis on clinical outcomes following liver transplantation (LT) remains unclear.

Articles evaluating the relationship between myosteatosis and the clinical outcomes of LT recipients were comprehensively retrieved from the Embase, PubMed, and Cochrane Library Central databases up to 1 October 2024.

Thirteen articles involving 3351 cases were included. Myosteatosis was related to increased mortality risk in patients undergoing LT (HR, 1.764; 95% CI, 1.469–2.120; p < 0.01). Patients with myosteatosis had significantly lower rates of 1-year (OR, 0.376; 95% CI, 0.299–0.473; p  < 0.01), 3-year (OR, 0.429; 95% CI, 0.353–0.522; p  < 0.01), and 5-year (OR, 0.448; 95% CI, 0.343–0.585; p  < 0.01) overall survival (OS), higher rates of postoperative complications (OR, 2.482; 95% CI, 1.710–3.601; p  < 0.01), 90-day mortality (OR, 4.097; 95% CI, 2.522–6.658; p  < 0.01), and early allograft dysfunction (EAD) (OR, 2.197; 95% CI, 1.572–3.071; p  < 0.01), and longer intensive care unit (ICU) (SMD, 0.411; 95% CI, 0.122–0.701; p  < 0.01) and hospital stays (SMD, 0.682; 95% CI, 0.503–0.860; p  < 0.01) than those without myosteatosis.

Myosteatosis is a potent predictor of poor prognosis and adverse perioperative outcomes in LT recipients. Early detection of myosteatosis can assist in guiding interventions and supportive care to improve the prognosis in the LT population. Furthermore, it is necessary to incorporate myosteatosis into clinical decision-making and selection criteria for LT.