(58) - Improvement in Frailty Is Associated with Improved Disability in Lung Transplantation

Abstract

s S31 aims of this study were to investigate: 1) the changes in pectoralis muscle area (PMA) after lung transplant, and 2) the association between PMA and other anthropomorphic and clinical variables. Methods: We conducted a retrospective review of all patients undergoing lung transplantation at a single center between January 2009 and December 2014. Utilizing TomoVision Slice-O-Matic software, two independent examiners measured PMA on a single slice at the carina from CT scans of the thorax obtained pre-transplant and 6 and 12 months post-transplant. Single variable regression and Pearson’s correlations were performed to assess the relationship between PMA and clinical variables. Results: Of the 73 patients who underwent lung transplantation, the most common indications were interstitial lung disease (ILD, 60.3%), followed by chronic obstructive pulmonary disease (COPD, 24.7%) and cystic fibrosis (9.6%). Twenty-four patients (33%) underwent single lung transplant, while 49 (67%) had double lung transplant. Overall, neither body mass index (BMI) nor PMA changed at 6 or 12 months post-transplant (p= 0.89 and 0.08 respectively by repeated measures ANOVA). Pre-transplant diagnosis significantly influenced change in PMA. In patients with ILD, there was a decrease in PMA compared with those without ILD (-13.7±3.7% vs. 14.8±8.9%, p= 0.001). However, patients with COPD had increased PMA compared with those without COPD (15.4±11.3% vs. -10.5±3.8%, p= 0.008). In addition, single lung transplant patients showed an 8.4±8.3% increase in PMA, while double lung recipients had an 11.3±4.4% decrease (p= 0.03). Finally, % change in PMA at 12 months correlated with pre-transplant weight (ρ = -0.306, p= 0.04), pre-transplant BMI (ρ = -0.309, p= 0.04), and % change in BMI at 12 months (ρ = 0.625, p< 0.0001). Conclusion: Analysis of thoracic CT scans provides a convenient, accurate measure of changes in muscle mass in the post-lung transplant population and correlates with changes in BMI. Patients with COPD gain muscle mass following lung transplantation while patients with ILD lose muscle mass. The mechanisms underlying these changes need to be further investigated.