Effect of body mass index of recipients on early prognosis after lung transplantation

Wang Dapeng; Li Xiaoshan; Xu Zhongping; Liang Chenglong; Hu Chunxiao; Xu Hongyang

doi:10.3969/j.issn.1674-7445.2023081

Volume 14 Issue 5

Sep. 2023

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Wang Dapeng, Li Xiaoshan, Xu Zhongping, et al. Effect of body mass index of recipients on early prognosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 669-675. doi: 10.3969/j.issn.1674-7445.2023081

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Effect of body mass index of recipients on early prognosis after lung transplantation

doi: 10.3969/j.issn.1674-7445.2023081

1.
Department of Intensive Care Unit, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China

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Corresponding author: Xu Hongyang, Email: xhy1912@aliyun.com
Received Date: 2023-04-12
Available Online: 2023-07-20
Publish Date: 2023-09-15

Abstract

Abstract

Objective To evaluate the effect of body mass index (BMI) on early prognosis of the recipients after lung transplantation. Methods Clinical data of 307 lung transplant recipients were retrospectively analyzed. According to preoperative BMI, all recipients were divided into the low (BMI <18.5 kg/m², n=114), normal (18.5 kg/m²≤BMI <24 kg/m², n=145) and high (BMI≥24.0 kg/m², n=48) BMI groups, respectively. Baseline data including age, sex, blood type, BMI, preoperative complications, preoperative pulmonary hypertension, and intraoperative use of extracorporeal membrane oxygenation (ECMO) of all recipients were compared among three groups. The survival rate of all recipients was estimated by Kaplan-Meier curve and the survival curve was delineated. The differences of survival rate were analyzed by log-rank test. The 30-, 90- and 180-d mortality risk of all recipients after lung transplantation in different BMI groups was compared by multivariate Cox regression analysis. Results There were significant differences in age and sex of recipients among three groups (both P<0.05). There was a significant difference regarding the 180-d survival rate after lung transplantation among different BMI groups (P<0.05). Multivariate Cox regression analysis showed that the 90-d mortality risk after lung transplantation in the high BMI group was 2.295 times higher than that in the normal BMI group [hazard ratio (HR) 2.295, 95% confidence interval (CI) 1.064-4.947, P=0.034]. In the high BMI group, the 180-d mortality risk after lung transplantation was 2.783 times higher compared with that in the normal BMI group (HR 2.783, 95%CI 1.333-5.810, P=0.006), and the 180-d mortality risk in the low BMI group was 2.181 times higher than that in the normal BMI group (HR 2.181, 95%CI 1.124-4.232, P=0.021). Conclusions Compared with the recipients with normal BMI, their counterparts with high and low preoperative BMI have higher mortality risk early after lung transplantation. Adjusting preoperative BMI to normal range contributes to improving early prognosis of lung transplant recipients.
- Body mass index,
- Lung transplantation,
- Recipient,
- Early prognosis,
- Survival rate,
- Primary graft failure,
- Obesity,
- Malnutrition

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References

[1]	SABASHNIKOV A, WEYMANN A, MOHITE PN, et al. Risk factors predictive of one-year mortality after lung transplantation[J]. Eur J Cardiothorac Surg, 2014, 46(6): e82-e88. DOI: 10.1093/ejcts/ezu383.
[2]	GRIMM JC, VALERO V 3RD, KILIC A, et al. Preoperative performance status impacts perioperative morbidity and mortality after lung transplantation[J]. Ann Thorac Surg, 2015, 99(2): 482-489. DOI: 10.1016/j.athoracsur.2014.09.038.
[3]	JAWITZ OK, RAMAN V, BECERRA D, et al. Factors associated with short- versus long-term survival after lung transplant[J]. J Thorac Cardiovasc Surg, 2022, 163(3): 853-860. DOI: 10.1016/j.jtcvs.2020.09.097.
[4]	MANNEM H, AVERSA M, KELLER T, et al. The lung transplant candidate, indications, timing, and selection criteria[J]. Clin Chest Med, 2023, 44(1): 15-33. DOI: 10.1016/j.ccm.2022.10.001.
[5]	PILEWSKI JM. Update on lung transplantation for cystic fibrosis[J]. Clin Chest Med, 2022, 43(4): 821-840. DOI: 10.1016/j.ccm.2022.07.002.
[6]	SUBRAMANIAN M, MEYERS BF. Lung transplant procedure of choice: bilateral transplantation versus single transplantation complications, quality of life, and survival[J]. Clin Chest Med, 2023, 44(1): 47-57. DOI: 10.1016/j.ccm.2022.10.003.
[7]	ALLEN JG, ARNAOUTAKIS GJ, WEISS ES, et al. The impact of recipient body mass index on survival after lung transplantation[J]. J Heart Lung Transplant, 2010, 29(9): 1026-1033. DOI: 10.1016/j.healun.2010.05.005.
[8]	CHRISTIE JD, EDWARDS LB, KUCHERYAVAYA AY, et al. The Registry of the International Society for Heart and Lung Transplantation: 29th adult lung and heart-lung transplant report-2012[J]. J Heart Lung Transplant, 2012, 31(10): 1073-1086. DOI: 10.1016/j.healun.2012.08.004.
[9]	BENDEN C, RIDOUT DA, EDWARDS LB, et al. Body mass index and its effect on outcome in children after lung transplantation[J]. J Heart Lung Transplant, 2013, 32(2): 196-201. DOI: 10.1016/j.healun.2012.11.002.
[10]	JENNERICH AL, PRYOR JB, WAI TYH, et al. Low body mass index as a barrier to lung transplant in cystic fibrosis[J]. J Cyst Fibros, 2022, 21(3): 475-481. DOI: 10.1016/j.jcf.2021.12.001.
[11]	YAMAMOTO H, SUGIMOTO S, SOH J, et al. The prognostic nutritional index is correlated negatively with the lung allocation score and predicts survival after both cadaveric and living-donor lobar lung transplantation[J]. Surg Today, 2021, 51(10): 1610-1618. DOI: 10.1007/s00595-021-02244-2.
[12]	ANDERSON MR, CANTU E, SHASHATY M, et al. Body mass index and cause-specific mortality after lung transplantation in the United States[J]. Ann Am Thorac Soc, 2023, 20(6):825-833. DOI: 10.1513/AnnalsATS.202207-613OC.
[13]	ATCHADE E, BOUGHABA A, DINH AT, et al. Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome[J]. Front Med (Lausanne), 2023, 10: 1160621. DOI: 10.3389/fmed.2023.1160621.
[14]	VERZELLONI SEF A, NG YIN LING C, AW TC, et al. Postoperative vasoplegia in lung transplantation: incidence and relation to outcome in a single-centre retrospective study[J]. Br J Anaesth, 2023, 130(6): 666-676. DOI: 10.1016/j.bja.2023.01.027.
[15]	中华医学会内分泌学分会肥胖学组. 中国成人肥胖症防治专家共识[J]. 中华内分泌代谢杂志, 2011, 27(9): 711-717. DOI: 10.3760/cma.j.issn.1000-6699.2011.09.003. Obesity Group of the Branch of Endocrinology of Chinese medical Association. Expert consensus on adult obesity prevention in China [J]. Chin J Endocrinol Metab, 2011, 27(9): 711-717. DOI: 10.3760/cma.j.issn.1000-6699.2011.09.003.
[16]	乔通, 王卫香, 高培玉, 等. 营养支持疗法在肺移植患者围手术期的应用[J]. 中华临床营养杂志, 2018, 26(1): 22-25. DOI: 10.3760/cma.j.issn.1674-635X.2018.01.004. QIAO T, WANG WX, GAO PY, et al. Nutritional support for lung transplant over the perioperative period[J]. Chin J Clin Nutr, 2018, 26(1): 22-25. DOI: 10.3760/cma.j.issn.1674-635X.2018.01.004.
[17]	SINGER JP, PETERSON ER, SNYDER ME, et al. Body composition and mortality after adult lung transplantation in the United States[J]. Am J Respir Crit Care Med, 2014, 190(9): 1012-1021. DOI: 10.1164/rccm.201405-0973OC.
[18]	KELLEHER MM, PHILLIPS R, BROWN SJ, et al. Skin care interventions in infants for preventing eczema and food allergy[J]. Cochrane Database Syst Rev, 2022, 11(11): CD013534. DOI: 10.1002/14651858.CD013534.pub3.
[19]	KOMATSU T, CHEN-YOSHIKAWA TF, OSHIMA A, et al. Severe underweight decreases the survival rate in adult lung transplantation[J]. Surg Today, 2017, 47(10): 1243-1248. DOI: 10.1007/s00595-017-1508-8.
[20]	DE LA TORRE MM, DELGADO M, PARADELA M, et al. Influence of body mass index in the postoperative evolution after lung transplantation[J]. Transplant Proc, 2010, 42(8): 3026-3028. DOI: 10.1016/j.transproceed.2010.07.078.
[21]	ABDULQAWI R, SALEH RA, DEVOL E, et al. Lung transplantation outcomes in underweight recipients: a single center experience[J]. Heliyon, 2023, 9(4): e15080. DOI: 10.1016/j.heliyon.2023.e15080.
[22]	RAMOS KJ, KAPNADAK SG, BRADFORD MC, et al. Underweight patients with cystic fibrosis have acceptable survival following lung transplantation: a United Network for Organ Sharing Registry Study[J]. Chest, 2020, 157(4): 898-906. DOI: 10.1016/j.chest.2019.11.043.
[23]	BIGELOW B, TOCI G, ETCHILL E, et al. Nutritional risk index: a predictive metric for mortality after lung transplant[J]. Ann Thorac Surg, 2021, 112(1): 214-220. DOI: 10.1016/j.athoracsur.2020.08.014.
[24]	KIM HH, JO KW, SHIM TS, et al. Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation[J]. Sci Rep, 2023, 13(1): 667. DOI: 10.1038/s41598-023-27864-1.
[25]	CHRISTAKOUDI S, TSILIDIS KK, EVANGELOU E, et al. Associations of obesity and body shape with erythrocyte and reticulocyte parameters in the UK Biobank cohort[J]. BMC Endocr Disord, 2023, 23(1):161. DOI: 10.1186/s12902-023-01423-1.
[26]	LEE V. Introduction to the dietary management of obesity in adults[J]. Clin Med (Lond), 2023, 23(4):304-310. DOI: 10.7861/clinmed.2023-0157.
[27]	BARILLAS-LARA MI, FAABORG-ANDERSEN CC, QUINTANA RA, et al. Clinical considerations and pathophysiological associations among obesity, weight loss, heart failure, and hypertension[J]. Curr Opin Cardiol, 2023, 38(5):447-455. DOI: 10.1097/HCO.0000000000001069.
[28]	TAKEUCHI M, SHINOZAKI T, KAWAKAMI K. Effectiveness of specific health check-ups in Japan for the primary prevention of obesity-related diseases: a protocol for a target trial emulation[J]. BMJ Open, 2023, 13(7):e070417. DOI: 10.1136/bmjopen-2022-070417.
[29]	SHU H, CHENG J, LI N, et al. Obesity and atrial fibrillation: a narrative review from arrhythmogenic mechanisms to clinical significance[J]. Cardiovasc Diabetol, 2023, 22(1):192. DOI: 10.1186/s12933-023-01913-5.
[30]	CICEKLI I, SAGLAM D, TAKAR N. A new perspective on metabolic syndrome with osteopontin: a comprehensive review[J]. Life (Basel), 2023, 13(7):1608. DOI: 10.3390/life13071608.
[31]	CRINER RN, CLAUSEN E, CANTU E. Primary graft dysfunction[J]. Curr Opin Organ Transplant, 2021, 26(3): 321-327. DOI: 10.1097/MOT.0000000000000876.
[32]	VAN SLAMBROUCK J, VAN RAEMDONCK D, VOS R, et al. A focused review on primary graft dysfunction after clinical lung transplantation: a multilevel syndrome[J]. Cells, 2022, 11(4): 745. DOI: 10.3390/cells11040745.
[33]	EHRSAM JP, SCHUURMANS MM, LAAGER M, et al. Recipient comorbidities for prediction of primary graft dysfunction, chronic allograft dysfunction and survival after lung transplantation[J]. Transpl Int, 2022, 35: 10451. DOI: 10.3389/ti.2022.10451.
[34]	HUNT ML, CANTU E. Primary graft dysfunction after lung transplantation[J]. Curr Opin Organ Transplant, 2023, 28(3): 180-186. DOI: 10.1097/MOT.0000000000001065.
[35]	LAUBACH VE, SHARMA AK. Mechanisms of lung ischemia-reperfusion injury[J]. Curr Opin Organ Transplant, 2016, 21(3): 246-252. DOI: 10.1097/MOT.0000000000000304.
[36]	SWAMINATHAN AC, MCCONNELL A, PESKOE S, et al. Evaluation of frailty measures and short-term outcomes after lung transplantation[J]. Chest, 2023, 164(1):159-168. DOI: 10.1016/j.chest.2023.01.017.
[37]	JUNG B, MOURY PH, MAHUL M, et al. Diaphragmatic dysfunction in patients with ICU-acquired weakness and its impact on extubation failure[J]. Intensive Care Med, 2016, 42(5): 853-861. DOI: 10.1007/s00134-015-4125-2.
[38]	RAJ I, KUMAR NAGAIAH S. Ultrasonography of diaphragm to predict extubation outcome[J]. Cureus, 2023, 15(3): e36514. DOI: 10.7759/cureus.36514.
[39]	是子豪, 周群燕, 杨航. 人体成分分析在肺移植患者中的应用与研究[J]. 临床肺科杂志, 2023, 28(2): 230-234. DOI: 10.3969/j.issn.1009-6663.2023.02.014. SHI ZH, ZHOU QY, YANG H. Application and research of body composition analysis in patients with lung transplantation[J]. J Clin Pulm Med, 2023, 28(2): 230-234. DOI: 10.3969/j.issn.1009-6663.2023.02.014.
[40]	HERMANS AJH, LAARHUIS BI, KOUW IWK, et al. Current insights in ICU nutrition: tailored nutrition[J]. Curr Opin Crit Care, 2023, 29(2): 101-107. DOI: 10.1097/MCC.0000000000001016.
[41]	王文静, 李小杉, 钱婷, 等. 肺移植术后肺部感染的研究现状[J]. 中国呼吸与危重监护杂志, 2022, 21(8): 550-555. WANG WJ, LI XS, QIAN T, et al. The present research status on pulmonary infections after lung transplantation[J]. Chin J Respir Crit Care Med, 2022, 21(8): 550-555.

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Effect of body mass index of recipients on early prognosis after lung transplantation

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Effect of body mass index of recipients on early prognosis after lung transplantation

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