Integrative Muscle-Adipose Score (IMAS)

Vollständiger Abstract

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Objective: To investigate the potential of integrating muscle and fat compartments into a novel and unified score for outcome prediction in a bicentric European cohort of LT recipients. Background: Body composition (BC) reflects nutritional status and metabolic reserves and influences outcomes after orthotopic liver transplantation (LT). Validated tools for predicting long-term survival after LT remain scarce. Increasing evidence highlights sex-specific disparities in post-transplant outcomes. Study Design: A total of 695 adult patients undergoing LT at Charité–Berlin (n=412, 2010 to 2020; discovery cohort) and University Hospital Aachen (n=283, 2010 to 2018; validation cohort) were included. CT-based BC was assessed at lumbar level 3/4. Muscle mass, quality, and adipose tissue were integrated into the integrative muscle-adipose score (IMAS) and correlated with survival and postoperative morbidity. Results: Median follow-up was 54 (discovery) and 47 months (validation). A total of 31% of recipients were female. IMAS quartiles significantly stratified overall survival in both cohorts ( P