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Transplantation |

Utility of Lumbar Central Sarcopenia in Predicting Early Functional Status Following Lung Transplantation FREE TO VIEW

Labib Gilles Debiane, MD; Chadi Hage, MD; Michael Asare-Sawiri; Mark Tann, MD; Babar Khan, MD
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Indiana University School of Medicine, Indianapolis, IN


Chest. 2015;148(4_MeetingAbstracts):1083A. doi:10.1378/chest.2277720
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Abstract

SESSION TITLE: Transplantation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Lung transplant candidates exhibit impairment in skeletal muscle mass and function, defined as sarcopenia, which has emerged as a potential risk factor for early poor transplant outcomes. In this study, we aim to explore the role of central sarcopenia, a radiographic marker of frailty, in predicting post-lung transplantation 6-minute walk distance (6MWD) 1-2 weeks after hospital discharge.

METHODS: We prospectively enrolled 38 consecutive patients who underwent lung transplantation at Indiana University Methodist Hospital between January 2013 and March 2014. We collected pre-transplant age, sex, body mass index (BMI), and 6MWD and post-transplant 6MWD at 1-2 weeks of discharge. Using the SliceOmatic v5.0 software, the axial skeletal muscle surface area at the mid-L3 vertebral body level was quantified on computed tomography scan by Hounsfield Unit thresholds -29 to +150. The surface area was then divided by the square of the height in meters to obtain the skeletal muscle index (SMI). Measurements were performed by two trained observers.

RESULTS: The age range was 17-72 (mean 56 ± 14) with 55.3% being male. 7.9% were underweight (BMI<18.5 Kg/m2), 34.2% normal weight (BMI 18.5-24.9), 55.3% overweight (BMI 25-29.9), and 2.6% obese (BMI≥30). The 6MWD ranged from 600 to 1,620 feet (39.5% exceeded 1,300 feet). The mean SMI was 49.05 cm2/m2 (± 9.27). While age correlated with post-transplant 6MWD (-0.54, p=0.002), we did not find a significant correlation between pre-transplant SMI and 6MWD (-0.11, p=0.533) or between BMI and 6MWD (-0.22, P=0.227). The overall Spearman correlation of BMI with SMI was significant (0.47, p=0.003). While this correlation was stronger among women (0.65, p=0.005), it was not significant for men (0.48, p=0.28).

CONCLUSIONS: In our preliminary analysis, pre-transplant lumbar SMI as a radiographic measure of central sarcopenia did not correlate with the early 6-minute walk test performance of lung transplant recipients.

CLINICAL IMPLICATIONS: While limited by a small sample size and a single-center experience, our study suggests that instead of SMI, alternative measures of body composition are needed to provide a reliable predictive value for lung transplant outcomes.

DISCLOSURE: The following authors have nothing to disclose: Labib Gilles Debiane, Chadi Hage, Michael Asare-Sawiri, Mark Tann, Babar Khan

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