Effect of Total Psoas Muscle Area and Serum Albumin on Outcomes After Lung Transplantation.

BACKGROUND

Sarcopenia of the psoas muscle and hypoalbuminemia indicate poor nutritional status, inflammation, and frailty in lung transplant (LT) candidates, correlating with worse post-transplant outcomes.

METHODS

Retrospective study of LT recipients (2015-2023) examining the association of total psoas muscle area (TPA) and serum albumin with hospital stay, survival, and pulmonary function.

RESULTS

One hundred thirty-two LT recipients (mean age 59.56 ± 10.65 years, BMI 26.73 ± 5.55 kg/m, 65% males), 95% underwent bilateral LT. Higher TPA was associated with shorter hospital and ICU stays (p = 0.001). Similarly, higher albumin levels were associated with reduced hospital and ICU stays (p < 0.001). Hospital survivors had higher TPA (17.5 ± 6.1 vs. 14.6 ± 5.2 cm, p = 0.02) and higher albumin levels (3.25 ± 0.73 vs. 2.75 ± 0.85 mg/dL, p = 0.01). Long-term survivors had higher TPA (17.8 ± 6.35 vs. 15.9 ± 5.51 cm, p = 0.07) and higher albumin levels (3.29 ± 0.75 vs. 2.97 ± 0.78 mg/dL, p = 0.01). On multivariate analysis, albumin and male gender remained independent predictors of hospital and long-term survival. TPA was positively associated with post-transplant pulmonary function based on FVC and FEV1 (p < 0.001), while albumin levels showed no association.

CONCLUSION

In the present study of LT recipients, higher TPA and albumin levels were linked to shorter hospitalization, and albumin independently predicted survival. TPA, but not albumin, was associated with pulmonary function post-transplant.