학술논문
Sarcopenia prevalence in pediatric intestinal transplant recipients: Implications on post-transplant outcomes.
Document Type
Academic Journal
Author
Raghu VK; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA.; Sico R; Department of Pediatric Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Rudolph JA; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA.; Mazariegos GV; Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Squires J; Department of Pediatric Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Squires JE; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA.
Source
Publisher: Munksgaard Country of Publication: Denmark NLM ID: 9802574 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3046 (Electronic) Linking ISSN: 13973142 NLM ISO Abbreviation: Pediatr Transplant Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Sarcopenia has been associated with poor surgical outcomes but has not been studied in pediatric intestinal transplantation. We aimed to determine sarcopenia prevalence in intestinal transplant recipients and the association of sarcopenia with outcomes.
Methods: We performed a cross-sectional retrospective chart review of intestinal transplant recipients from 2000-present. We estimated total psoas muscle area (tPMA) at L3-L4 and L4-L5 from computed tomography scans prior to or in the immediate peri-operative period. Sarcopenia was defined by tPMA below the 5th percentile for age and sex. We built a Cox-proportional hazards model to determine the association between sarcopenia and patient and graft survival.
Results: Of the 56 intestinal transplant recipients included, 36 (64%) were sarcopenic. Graft survival was 79% at one year and 59% at five years. Overall patient survival was 86% at one year and 76% at five years. Peri-transplant sarcopenia was associated with improved graft survival (Hazard ratio 0.42, 95% confidence interval: 0.20-0.88) but not overall survival (Hazard ratio 0.47, 95% confidence interval: 0.19-1.20).
Conclusions: In this first report of sarcopenia in pediatric intestinal transplant, we found a high sarcopenia prevalence without an association with worse outcomes. The potential improved graft survival in sarcopenic patients along with underlying mechanisms warrant further exploration.
(© 2022 Wiley Periodicals LLC.)
Methods: We performed a cross-sectional retrospective chart review of intestinal transplant recipients from 2000-present. We estimated total psoas muscle area (tPMA) at L3-L4 and L4-L5 from computed tomography scans prior to or in the immediate peri-operative period. Sarcopenia was defined by tPMA below the 5
Results: Of the 56 intestinal transplant recipients included, 36 (64%) were sarcopenic. Graft survival was 79% at one year and 59% at five years. Overall patient survival was 86% at one year and 76% at five years. Peri-transplant sarcopenia was associated with improved graft survival (Hazard ratio 0.42, 95% confidence interval: 0.20-0.88) but not overall survival (Hazard ratio 0.47, 95% confidence interval: 0.19-1.20).
Conclusions: In this first report of sarcopenia in pediatric intestinal transplant, we found a high sarcopenia prevalence without an association with worse outcomes. The potential improved graft survival in sarcopenic patients along with underlying mechanisms warrant further exploration.
(© 2022 Wiley Periodicals LLC.)