Abstract Introduction The association of changes in skeletal muscle mass and quality during the waiting time with outcomes of lung transplantation (LT) remains unclear. We aimed to examine the association of changes in skeletal muscle mass and quality during the waiting time, as well as preoperative skeletal muscle mass and quality, with outcomes of LT. Methods This study included individuals who underwent LT from brain‐dead donors. Skeletal muscle mass (cm 2 /m 2 ) and quality (mean Hounsfield units [HU]) of the erector spinae muscle at the 12th thoracic level were evaluated using computed tomography. Preoperative skeletal muscle mass and quality, and their changes during the waiting time were calculated. We evaluated the associations among mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, 6‐minute walk distance at discharge, and 5‐year survival after LT. Results This study included 98 patients. The median waiting time was 594.5 days (interquartile range [IQR], 355.0–913.0). The median changes in skeletal muscle mass and quality were −4.4% (IQR, −13.3–3.1) and −2.9% (IQR, −16.0–4.1), respectively. Severe low skeletal muscle mass at LT was associated with prolonged ICU LOS (B = 8.46, 95% confidence interval [CI]: .51–16.42) and hospital LOS (B = 36.00, 95% CI: 3.23–68.78). Pronounced decrease in skeletal muscle mass during the waiting time was associated with prolonged MV duration (B = 7.85, 95% CI: .89–14.81) and ICU LOS (B = 7.97, 95% CI: .83–15.10). Conclusion Maintaining or increasing skeletal muscle mass during the waiting time would be beneficial to improve the short‐term outcomes of LT.
Abstract Introduction The percentage of low attenuation area (%LAA) on computed tomography (CT) is useful for evaluating lung emphysema, and higher %LAA was observed in patients with chronic lung allograft dysfunction (CLAD). This study investigated the relationship between the %LAA and the development of CLAD after bilateral lung transplantation (LT). Methods We conducted a single‐center retrospective study of 75 recipients who underwent bilateral LT; the recipients were divided into a CLAD group ( n = 30) and a non‐CLAD group ( n = 45). The %LAA was calculated using CT and compared between the two groups from 4 years before to 4 years after the diagnosis of CLAD. The relationships between the %LAA and the percent baseline values of the pulmonary function test parameters were also calculated. Results The %LAA was significantly higher in the CLAD group than in the non‐CLAD group from 2 years before to 2 years after the diagnosis of CLAD ( P < .05). In particular, patients with bronchiolitis obliterans syndrome (BOS) exhibited significant differences even from 4 years before to 4 years after diagnosis ( P < .05). Significant negative correlations between the %LAA and the percent baseline values of the forced expiratory volume in 1 s ( r = −.36, P = .0031), the forced vital capacity ( r = −.27, P = .027), and the total lung capacity ( r = −.40, P < .001) were seen at the time of CLAD diagnosis. Conclusion The %LAA on CT was associated with the development of CLAD and appears to have the potential to predict CLAD, especially BOS, after bilateral LT.
