Body Composition and Mortality after Adult Lung Transplantation in the United States

• DOI: 10.1164/rccm.201405-0973oc
• Publication Date: 2014-09-18T20:54:02Z
• Authors: Jonathan P. Singer; Eric R. Peterson; Mark E. Snyder; Patricia P. Katz; Jeffrey A. Golden; Frank D’Ovidio; Matthew Bacchetta; Joshua R. Sonett; Jasleen Kukreja; Lori Shah; Hilary Robbins; Kristin Van Horn; Rupal J. Shah; Joshua M. Diamond; Nancy Wickersham; Li Sun; Steven Hays; Selim M. Arcasoy; Scott M. Palmer; Lorraine B. Ware; Jason D. Christie; David J. Lederer
• Keywords: Underweight

Obesity and underweight are contraindications to lung transplantation based on their associations with mortality in studies performed before implementation of the allocation score (LAS)-based organ system United States Objectives: To determine body mass index (BMI) plasma leptin levels survival after transplantation.We used multivariable-adjusted regression models examine between BMI 1-year 9,073 adults who underwent May 2005 June 2011, 599 Lung Transplant Outcomes Group study participants. We measured fat skeletal muscle using whole-body dual X-ray absorptiometry 142 adult transplant candidates.Adjusted rates were similar among normal weight (BMI 18.5-24.9 kg/m(2)), overweight 25.0-29.9), class I obese 30-34.9) recipients. Underweight < 18.5) was associated a 35% increased rate death (95% confidence interval, 10-66%). Class II-III obesity ≥ 35 kg/m(2)) nearly twofold increase (hazard ratio, 1.9; 95% 1.3-2.8). Higher surgery without cardiopulmonary bypass (P for interaction = 0.03). A greater than or equal 30 kg/m(2) 26% sensitive 97% specific total fat-defined obesity.A 30.0-34.9 is not LAS era, perhaps because its low sensitivity obesity. The association suggests need validate alternative methods measure candidates transplantation. may no longer contraindicate