Longitudinal Changes in CT-Derived Vertebral Trabecular Attenuation and Psoas Muscle Density After Liver Transplantation for Hepatocellular Carcinoma

Background and Objectives: Hepatocellular carcinoma (HCC) is a major indication for liver transplantation (LT); however, longitudinal musculoskeletal changes detectable by computed tomography (CT) during the first postoperative year remain insufficiently characterized. The aim of this study is to compare baseline CT-derived bone and muscle parameters between patients undergoing LT for HCC and controls and to evaluate longitudinal changes during the first postoperative year. Materials and Methods: This retrospective study included 64 patients who underwent LT for HCC and had technically adequate non-contrast abdominal CT examinations at baseline, postoperative day 180 (POD180), and postoperative day 365 (POD365). The control group comprised 64 patients undergoing non-contrast abdominal CT for urinary stone evaluation. CT-derived measures included L1-L4 vertebral trabecular attenuation, psoas muscle area (PMA), the psoas muscle index (PMI), and psoas muscle density (PMD). Repeated-measures analyses and adjusted linear mixed-effects models evaluated longitudinal changes within the HCC cohort.