Preoperative phase angle is not associated with postoperative recovery in living liver donors: A prospective observational study

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Background: Phase angle (PA) has been proposed as a prognostic factor for evaluating postoperative outcomes across various types of surgery.In this study, we investigated whether preoperative PA measured in living liver donors is associated with postoperative recovery.Methods: Donors aged over 19 years, scheduled for elective purely laparoscopic donor hepatectomy, were included.Each donor underwent bioimpedance analysis (BIA), including PA, on the day before surgery (PA pre ) and the third postoperative day (PA POD3 ) using the InBody S10 (InBody Co., Ltd, Seoul, Korea).Postoperative recovery quality was assessed using the Korean version of the quality of recovery (QoR-15K).All donors completed the QoR-15K on POD3 and POD21 to evaluate their recovery following surgery and anesthesia.Results: The mean age of the participants was 38.7±13.2years, and 24 male donors (59%) were included.PA POD3 significantly decreased compared to PA pre (5.42±0.97 vs. 5.99±0.76;mean difference: -0.57, p=0.004).The extracellular water ratio (ECWR) on POD3 increased compared to preoperative levels (0.391±0.011 vs. 0.378±0.007;mean difference: 0.013, p<0.001).However, skeletal muscle mass index (SMI) did not significantly change over time (SMI pre : 7.5±1.1;SMI POD3 : 8.0±1.2;p=0.67).Neither PA pre nor ECWR pre was associated with QoR-15K scores on POD3.However, SMI pre was significantly associated with QoR-15K on POD3, but not on POD21.In the logistic regression model, preoperative BIA variables were not associated with in-hospital complications.Conclusion: While PA pre was not associated with postoperative recovery or complications, a higher SMI was identified as a significant predictor of better recovery, suggesting its potential use as a screening tool in living liver donors.

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