scholarly journals Skeletal Muscle Adiposity and Outcomes in Candidates for Lung Transplantation: A Lung Transplant Body Composition Cohort Study

2020 ◽  
Author(s):  
M.R. Anderson ◽  
I. Easthausen ◽  
G. Gallagher ◽  
J. Udupa ◽  
Y. Tong ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Cohort Study ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Muscle Adiposity

scholarly journals Skeletal muscle adiposity and outcomes in candidates for lung transplantation: a lung transplant body composition cohort study

Thorax ◽  
2020 ◽  
Vol 75 (9) ◽  
pp. 801-804 ◽  
Author(s):  
Michaela R Anderson ◽  
Imaani Easthausen ◽  
Grace Gallagher ◽  
Jayaram Udupa ◽  
Yubing Tong ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Lung Transplant ◽  
Abdominal Muscle ◽  
Thigh Muscle ◽  
Risk Of Death ◽  
Increased Risk ◽  
Muscle Attenuation ◽  
Muscle Adiposity ◽  
Transplant Candidates

CT measurement of body composition may improve lung transplant candidate selection. We assessed whether skeletal muscle adipose deposition on abdominal and thigh CT scans was associated with 6 min walk distance (6MWD) and wait-list survival in lung transplant candidates. Each ½-SD decrease in abdominal muscle attenuation (indicating greater lipid content) was associated with 14 m decrease in 6MWD (95% CI −20 to −8) and 20% increased risk of death or delisting (95% CI 10% to 40%). Each ½-standard deviation decrease in thigh muscle attenuation was associated with 15 m decrease in 6MWD (95% CI −21 to −10). CT imaging may improve candidate risk stratification.

scholarly journals Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2884
Author(s):  
Mara Weber Gulling ◽  
Monica Schaefer ◽  
Laura Bishop-Simo ◽  
Brian C. Keller
Keyword(s):  
Body Composition ◽  
Lung Transplantation ◽  
Body Mass ◽  
Lung Transplant ◽  
Assessment Tools ◽  
Transplant Recipients ◽  
Body Composition Assessment ◽  
Lung Transplant Recipients ◽  
End Stage

Lung transplantation offers patients with end-stage lung disease an opportunity for a better quality of life, but with limited organ availability it is paramount that selected patients have the best opportunity for successful outcomes. Nutrition plays a central role in post-surgical outcomes and, historically, body mass index (BMI) has been used as the de facto method of assessing a lung transplant candidate’s nutritional status. Here, we review the historical origins of BMI in lung transplantation, summarize the current BMI literature, and review studies of alternative/complementary body composition assessment tools, including lean psoas area, creatinine-height index, leptin, and dual x-ray absorptiometry. These body composition measures quantify lean body mass versus fat mass and may provide a more comprehensive analysis of a patient’s nutritional state than BMI alone.

scholarly journals Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

2019 ◽  
Author(s):  
Mara Weber Gulling ◽  
Monica Schaefer ◽  
Laura Bishop-Simo ◽  
Brian C. Keller
Keyword(s):  
Body Composition ◽  
Lung Transplantation ◽  
Body Mass ◽  
Lung Transplant ◽  
Assessment Tools ◽  
Transplant Recipients ◽  
Body Composition Assessment ◽  
Lung Transplant Recipients ◽  
End Stage

Lung transplantation offers patients with end stage lung disease an opportunity for a better quality of life, but with limited organ availability it is paramount that selected patients have the best opportunity for successful outcomes. Nutrition plays a central role in post-surgical outcomes and historically, body mass index (BMI) has been used as the de facto method of assessing a lung transplant candidate’s nutritional status. Here we review the historical origins of BMI in lung transplantation, summarize the current BMI literature, and review studies of alternative/complementary body composition assessment tools, including lean psoas area, creatinine-height index, leptin, and dual x-ray absorptometry. These body composition measures quantify lean body mass versus fat mass and may provide a more comprehensive analysis of a patient’s nutritional state than BMI alone.

The association between geriatric assessment, body composition measures, and treatment-related toxicity in elderly cancer patients: A prospective cohort study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12047-12047
Author(s):  
Shlomit Strulov Shachar ◽  
Gil Barsela ◽  
Avivit Peer ◽  
Mor Tal Moskovitz ◽  
Avital Bareket-Samish ◽  
...  
Keyword(s):  
Older Adults ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Cohort Study ◽  
Geriatric Assessment ◽  
Frailty Index ◽  
Treatment Decisions ◽  
Tumor Type ◽  
Skeletal Muscle Index ◽  
Patients With Cancer

12047 Background: Treatment decisions in older adults with cancer are confounded by limited evidence due to their under-representation in clinical trials and as associations between geriatric assessment findings, body composition measures, treatment-related toxicity, and treatment effectiveness have yet to be fully elucidated. We investigated the relationship between geriatric assessment results, skeletal muscle measures, and treatment-related toxicity in older adults with cancer. Methods: This prospective single-center cohort study included patients with cancer > 65 years of age with advanced lung, breast, or genitourinary (GU) cancer who received systemic treatment (chemotherapy, biologic therapy, immunotherapy, or combination), and had available CT scans. Patients completed the Comprehensive Geriatric assessment (CGA) and 36-item Carolina Frailty Index (CFI) was calculated to classify them as robust ( < 0.2), pre-frail (0.2-0.35), or frail ( > 0.35). For each patient, skeletal muscle area (SMA) and density (SMD) were analyzed from CT scan L3 lumbar segments using Slice-O-Matic software. SMA and height (m2) were used to calculate skeletal muscle index (SMI). Skeletal muscle gauge (SMG) was created by multiplying SMI x SMD. Sarcopenia was defined as having SMI < 41 cm2/m2 for males and < 38 cm2/m2 for females. The associations between study variables and the occurrence of at least one adverse event (AE) grade ≥2 were analyzed using the Pearson's chi-squared test. The study was approved by the IRB of Rambam Health Care Campus. All patients signed an informed consent. Results: Overall, 51 patients (recruited between 5/2015 and 1/2020) were included in the final analysis. Median (interquartile [IQR]) age was 72 (68-76) years; 59% were male; 51%, 28%, and 22% had lung, breast, and GU cancer respectively. The most common treatment received was doublet chemotherapy (49%). All patients except 3 (6%) completed the CGA and CFI was calculated; 29%, 26%, and 39% were classified as robust, pre-frail, and frail, respectively. Median (IQR) SMG was 1251 (1104-1497) AU; median (IQR) SMI was 42 (39-48) cm2/m2; 31% were defined as sarcopenic. Overall, 45% of patients experienced at least one AE grade ≥2; 24% experienced at least one AE grade≥3. No statistically significant association was found between treatment-related toxicity and sex, age, tumor type, treatment, or CFI category. Yet, having low SMG (categorically, by tertile) was significantly associated with having at least one AE grade≥2 (p = 0.03) as was being sarcopenic (p = 0.02). Conclusions: Low SMG and sarcopenia are associated with treatment-related toxicity in older patients with cancer. Further research and better understanding of this association could help optimize treatment decisions (e.g., choice of regimen, dosing) and interventions in this population.

Associations between Body Composition and Mortality: A Large Population-Based Cohort Study

2020 ◽  
Author(s):  
Fu-Rong Li ◽  
Pei-Liang Chen ◽  
Xin Cheng ◽  
Hai-Lian Yang ◽  
Wen-Fang Zhong ◽  
...  
Keyword(s):  
Body Composition ◽  
Cohort Study ◽  
Large Population ◽  
Population Based

Clinical characteristics and epidemiology survey of lung transplantation recipients accepting surgeries during COVID-19 pandemic：from area near Hubei Province (Preprint)

2020 ◽  
Author(s):  
Lingxiao Qiu ◽  
Shanshan Chen ◽  
Cong Wang ◽  
Caihong Liu ◽  
Huaqi Wang ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Clinical Characteristics ◽  
Lung Transplant ◽  
The Novel ◽  
Web Based ◽  
Transplant Program ◽  
Medical Institutions ◽  
Survey Results ◽  
Wbc Count ◽  
Novel Coronavirus

BACKGROUND Lung transplantation recipients (LTx) are more susceptible to severe acute respiratory syndrome-corona virus-2 (SARS-Cov-2) and suffer severer outcomes than healthy subjects. OBJECTIVE Here we aim to analyze whether it was appropriate to maintain lung transplant programs in medical institutions accepting coronavirus disease 2019 (COVID-19) patients. METHODS Methods: the clinical characteristics, laboratory testing, and epidemiology survey results of 10 LTx recipients undergoing allograft lung transplantation surgeries in the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic were collected. A web-based epidemiology questionnaire was used to collect the information of LTx recipients after discharge. RESULTS A total of 10 LTx recipients were identified. The main cause of lung transplantation was idiopathic interstitial pneumonia (60%), with another rare case of cystic fibrosis. Comorbidities involved hyperlipidemia, subclinical hyperthyroidism, diabetes, viral hepatitis of type B. The average white blood cell (WBC) count and average lymphocyte count were 9.5±3.9×109 cells/liter and 1.7±1.1×109 cells/liter, respectively. 40% of the LTx recipients had lymphopenia. Impaired alanine aminotransferase (ALT) and aspartate transaminase (AST) were observed in LTx recipients. Good habitats of hand hygiene (100%), wearing protective masks behaviors (100%), indoor ventilation behaviors (100%), indoor disinfection measures (83%), personal tableware (67%), separate room (100%), personal bedsheets/ quilts (100%) and drinking glasses (100%) were observed during the follow-up. None of the LTx recipients or their family members get infected with SARS-CoV-2 during the novel coronavirus pandemic. CONCLUSIONS Under the premise of taking appropriate preventive measures during hospitalization and after discharge, the lung transplant program can be maintained in the medical institution that accepts patients with COVID-19. INTERNATIONAL REGISTERED REPORT RR2-doi: https://doi.org/10.1101/2020.07.06.20147264

scholarly journals Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 309
Author(s):  
Kun-Yun Yeh ◽  
Hang Huong Ling ◽  
Shu-Hang Ng ◽  
Cheng-Hsu Wang ◽  
Pei-Hung Chang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Head And Neck Cancer ◽  
Mass Loss ◽  
Lean Mass ◽  
Recurrence Free Survival ◽  
Skeletal Muscle Index ◽  
Free Survival ◽  
Prognostic Predictor ◽  
Appendicular Skeletal Muscle

Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.

scholarly journals The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

2021 ◽  
Vol 7 (8) ◽  
pp. 639
Author(s):  
Yae-Jee Baek ◽  
Yun-Suk Cho ◽  
Moo-Hyun Kim ◽  
Jong-Hoon Hyun ◽  
Yu-Jin Sohn ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Fungal Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Transplant Recipients ◽  
Tertiary Center ◽  
Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

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