(144) Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis

Thursday, November 3, 2022

12:00 PM – 12:40 PM ET

Presenting Author(s)

Ann L. Jennerich, MD, MS, ATSF

Assistant Professor of Medicine
University of Washington
Seattle, Washington, United States

Co-Author(s)

LD

Lois Downey, MA

United States
CG

Chris Goss, MD, MS, FCCP

Professor
University of Washington, United States
Siddhartha G. Kapnadak, MD (he/him/his)

Associate Professor
Univ. of Washington
Seattle, Washington, United States
JP

Joseph B. Pryor, MD

United States
Kathleen J. Ramos, MD, MS (she/her/hers)

Assistant Professor
Univ. of Washington
Seattle, Washington, United States

Background: Low muscle mass is common in patients undergoing lung transplantation and may be linked to worse post-transplant outcomes. However, existing studies assessing muscle mass and post-transplant outcomes include few patients with cystic fibrosis (CF). To address this limitation, we identified a cohort of patients with CF and examined the relationship between pre-transplant muscle mass measured by computed tomography (CT) and post-transplant outcomes.

Methods: Between May 1993 and December 2018, 152 adults with CF received lung transplants at our institution. Of these, 83 met inclusion criteria and had usable CT scans. Using Cox proportional hazards regression, we evaluated the association between pre-transplant thoracic skeletal muscle index (SMI) and our primary outcome of death following lung transplantation. Secondary outcomes, including days to post-transplant extubation and post-transplant hospital and intensive care unit (ICU) length of stay, were assessed using linear regression. We also examined associations between thoracic SMI and pre-transplant pulmonary function and 6-minute walk distance.

Results: There was no association between pre-transplant thoracic SMI and death following lung transplantation (HR 1.025; 95% CI 0.948, 1.109), days to post-transplant extubation, or post-transplant hospital or ICU length of stay. There was an association between pre-transplant thoracic SMI and pre-transplant FEV1% predicted (p=0.002), with higher SMI associated with higher FEV1% predicted.

Conclusions: We did not identify a significant relationship between pre-transplant thoracic SMI and post-transplant outcomes in patients with CF. There was an association between thoracic SMI and pre-transplant pulmonary function, confirming the potential value of sarcopenia as a marker of disease severity.

Acknowledgements: KJR is supported by the National Institutes of Health (NIH) K23HL138154, Cystic Fibrosis Foundation (CFF) RAMOS17A0, and CHEST Foundation Cystic Fibrosis Grant; ALJ is supported by the NHLBI of the NIH under award number K23HL128793 as well as the CFF (LONG17A0). CHG receives funding from the NIH [UM1 HL119073, P30 DK089507, U01 HL114589, UL1 TR000423], the CFF and the FDA [R01 FD003704, R01 FD006848].

References: