Pre‐transplant wasting (as measured by muscle index) is a novel prognostic indicator in lung transplantation

Abstract

Low muscle index at lung transplantation is associated with worse survival and increased hospital LOS.

Thoracic muscle cross-sectional area is associated with hospital length of stay post lung transplantation: a retrospective cohort study

“…These findings are consistent with previous reports in patient populations undergoing major surgical procedures such as general surgery, liver and renal transplantation where core muscle size from abdominal CT was associated with longer hospital stay, higher rates of infection, and increased rates of post‐transplant mortality . In lung transplantation, pre‐transplant abdominal muscle CSA has been shown to be associated with ICU and hospital length of stay . Kelm et al .…”

“…Kelm et al . observed that muscle CSA was associated with three‐year survival in a selected sample of 36 lung transplant recipients with available abdominal CT scans. This is in contrast to the present study and that of Weig et al .…”

“…In a recent systematic review of 19 studies in liver transplantation, low skeletal muscle mass quantified with abdominal CT was prevalent (range 22–70%) and associated with waiting list and post‐transplant mortality . Similarly, in lung transplant patients, muscle CSA from abdominal CT has been associated with post‐transplant outcomes such as intensive care unit (ICU) and hospital length of stay . In patients with chronic obstructive pulmonary disease (COPD), muscle CSA from chest CT has been associated with disease severity , exercise capacity , and mortality .…”

The sarcopenia index: A novel measure of muscle mass in lung transplant candidates

“…The inter‐rater agreement has previously been demonstrated to be excellent. Kelm et al reported the inter‐rater Pearson correlation coefficient ( r ) for muscle index measurements to be 0.998 (95% CI, 0.997‐ 0.999) . We calculated body surface area with the Mosteller formula: body surface area in m 2 = (height in cm × weight in kg/3600) 1/2 .…”

Report from the American Society of Transplantation on frailty in solid organ transplantation

“…2 Biomarkers for frailty have been suggested, based on the concept that aging represents a low-grade chronic inflammatory process, sometimes termed "inflammaging." 13 Sarcopenia, like frailty, may be a risk factor for worse outcomes in lung transplant candidates; however, data are conflicting, with some studies showing lower pretransplant skeletal muscle mass measured radiographically being a risk factor for worse outcomes, 9,14 and others showing risk for longer hospital stays but not mortality. [3][4][5] Sarcopenia (loss of skeletal muscle mass) may be a precursor to the development of frailty and its adverse health outcomes.…”