Association of Body Mass Index with Lung Transplantation Survival in the United States Following Implementation of the Lung Allocation Score

Overview

Journal J Thorac Cardiovasc Surg

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2017 Dec 19

PMID 29249487

Citations 17

Authors

Ramiro Fernandez

Niloufar Safaeinili

Chitaru Kurihara

David D Odell

Manu Jain

Malcolm M DeCamp

G R Scott Budinger

Ankit Bharat

Affiliations

Soon will be listed here.

Abstract

Background: The association of body mass index (BMI) with survival after lung transplantation remains controversial, owing to conflicting evidence in the literature. Previous reports have used traditional BMI categories, included patients who underwent transplantation before implementation of the lung allocation score (LAS), or were limited by single-center experiences. Here we evaluated the association of individual BMI units with short-term and long-term mortality in a large national database following implementation of the LAS.

Methods: The Scientific Registry of Transplant Recipients database was used to collect data for 17,233 adult lung transplantations performed between May 2005 and June 2016. The primary outcome was all-cause mortality at 90 days and 1 year posttransplantation. Logistic regression modeling was used to independently predict mortality per BMI unit, adjusting for donor and recipient factors.

Results: BMI was an independent predictor of mortality at both 90 days and 1 year. At 90 days, a BMI of 25 was associated with the lowest predicted probability of death (0.053; 95% confidence interval [CI], 0.047-0.049), with increased odds of mortality at BMI ≤20 and ≥28. At 1 year, a BMI of 26 was associated with the lowest predicted probability of death (0.12; 95% CI, 0.11-0.13), with increased odds of mortality at BMI ≤24 and ≥28.

Conclusions: Each individual BMI unit has a quantifiable effect on posttransplantation survival, and the patterns of effect do not fit into the predefined BMI categories. The mortality risk associated with BMI should be considered by transplant centers when making listing decisions and by regulatory bodies for estimating expected outcomes.

Citing Articles

One-Year Mortality After Lung Transplantation: Experience of a Single French Center Between 2012 and 2021.

Hoang T, Han L, Hirschi S, Degot T, Leroux J, Falcoz P Ann Transplant. 2024; 29:e944420.

PMID: 39161071 PMC: 11344474. DOI: 10.12659/AOT.944420.

Body mass Index does not impact long-term survival of patients with idiopathic pulmonary fibrosis undergoing lung transplantation.

Lushaj E, DeCamp M, Maloney J, Leverson G, De Oliveira N, McCarthy D Front Transplant. 2024; 2:1146779.

PMID: 38993923 PMC: 11235251. DOI: 10.3389/frtra.2023.1146779.

Baseline Lung Allograft Dysfunction After Bilateral Lung Transplantation Is Associated With an Increased Risk of Death: Results From a Multicenter Cohort Study.

Keller M, Sun J, Alnababteh M, Ponor L, Shah P, Mathew J Transplant Direct. 2024; 10(7):e1669.

PMID: 38953039 PMC: 11216668. DOI: 10.1097/TXD.0000000000001669.

Impact of recipient and donor pretransplantation body mass index on early postosperative complications after lung transplantation.

Atchade E, De Tymowski C, Lepitre E, Zappella N, Snauwaert A, Jean-Baptiste S BMC Pulm Med. 2024; 24(1):161.

PMID: 38570744 PMC: 10988822. DOI: 10.1186/s12890-024-02977-z.

Lung transplantation outcomes in underweight recipients: A single center experience.

Abdulqawi R, Saleh R, Devol E, Aldakhil H, Saleh W, Hashim M Heliyon. 2023; 9(4):e15080.

PMID: 37095975 PMC: 10121808. DOI: 10.1016/j.heliyon.2023.e15080.

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