Evidence map›Paper›PMID 40638459›Full record

SynthesisRevista da Associacao Medica Brasileira (1992)2025

Opportunistic computed tomography-based sarcopenia screening and mortality after liver transplantation: a systematic review and meta-analysis.

Daniel Alvarenga Fernandes, Daniel Bohn, Pedro Antune da Silva Pereira, Mila Mucci, Vittor Hugo Andrade Marques, Paula Juliano Lopes de Faria, Elaine Cristina de Ataide, João Rafael Terneira Vicentini, Nelson Marcio Gomes Caserta, Ilka de Fátima Santana Ferreira Boin

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Revista da Associacao Medica Brasileira (1992), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Abdominal Organ Transplantation: Noteworthy Literature in 2025.Seminars in cardiothoracic and vascular anesthesia · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Daniel Alvarenga FernandesUniversidade Estadual de Campinas, School of Medical Sciences, Department of Anesthesiology, Oncology, and Radiology - Campinas (SP), Brazil.ORCID http://orcid.org/0000-0001-8138-1316
Daniel BohnUniversidade Federal de Pelotas, School of Medicine - Pelotas (RS), Brazil.ORCID http://orcid.org/0000-0002-6891-7910
Pedro Antune da Silva PereiraUniversity of Toronto, Department of Radiology - Toronto (ON), Canada.ORCID http://orcid.org/0000-0003-2833-9295
Mila MucciDepartment of Medicine, Santa Casa Hospital - Ribeirão Preto (SP), Brazil.ORCID http://orcid.org/0000-0003-1652-6050
Vittor Hugo Andrade MarquesFaculty of Medicine - Ipatinga (MG), Brazil.ORCID http://orcid.org/0000-0002-8603-4126
Paula Juliano Lopes de FariaUniversidade Estadual de Campinas, School of Medical Sciences, Department of Surgery, Liver Transplant Unit - Campinas (SP), Brazil.ORCID http://orcid.org/0000-0002-7262-2824
Elaine Cristina de AtaideUniversidade Estadual de Campinas, School of Medical Sciences, Department of Surgery, Liver Transplant Unit - Campinas (SP), Brazil.ORCID http://orcid.org/0000-0002-2672-7326
João Rafael Terneira VicentiniDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School - Boston (MA), United States.ORCID http://orcid.org/0000-0002-0838-1659
Nelson Marcio Gomes CasertaUniversidade Estadual de Campinas, School of Medical Sciences, Department of Anesthesiology, Oncology, and Radiology - Campinas (SP), Brazil.ORCID http://orcid.org/0000-0001-8404-8092
Ilka de Fátima Santana Ferreira BoinUniversidade Estadual de Campinas, School of Medical Sciences, Department of Surgery, Liver Transplant Unit - Campinas (SP), Brazil.ORCID http://orcid.org/0000-0002-1165-2149

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to investigate the diagnosis of sarcopenia in chronic liver disease by opportunistic computed tomography screening using the Psoas Muscle Index method as a predictor of mortality after liver transplantation.

methodsWe systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials from July 2014 to July 2024. We restricted inclusion in this meta-analysis to observational studies and clinical trials on adult patients with chronic liver disease diagnosed with sarcopenia by computed tomography undergoing liver transplantation or on a waiting list. We included the one with a larger sample size for studies with overlapping populations. We excluded studies with therapeutic interventions, animal experiments, cell-line studies, editorial pieces, commentaries, review articles, and case reports.

resultsAfter the removal of duplicate records and ineligible studies, 163 remained and were thoroughly reviewed based on inclusion criteria. Of these, a total of 11 studies were included in qualitative synthesis and four studies were included in quantitative analysis (meta-analysis), comprising 382 patients. Patients with muscle mass loss after liver transplantation diagnosed by computed tomography scan using the Psoas Muscle Index method had a 4.1 times higher risk of death than non-sarcopenic patients (random-effects model: OR 4.1386; 95%CI 2.4215-7.0730; p<0.0001). Interpretatively, a scale with an I2 value close to 0% indicates no heterogeneity. The other criteria also did not reject the hypothesis of homogeneity among the articles.

conclusionsPatients with muscle mass loss diagnosed by computed tomography using the Psoas Muscle Index method had a fourfold increased mortality risk after transplantation. The findings reinforce the need to identify sarcopenic patients preoperatively to optimize liver transplantation outcomes. Using the Psoas Muscle Index, an opportunistic diagnosis by computed tomography scan can be helpful in this setting.

Indexed as

Liver TransplantationSarcopeniaTomography, X-Ray ComputedHumansPsoas Muscles

Identifiers

PMID40638459
PMCPMC12245067

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.