Franco-Palacios Domingo J, Franco-Palacios Carlos R, Crowley Sarah, Allenspach Lisa L, Stagner Lisa, Corrales Julio Pinto, Olexsey Kaitlin, Waynick Lisa, Simanovski Jane, Bhatti Humza, Laier Ryann, Myszenski Adele, Wang Yichu, Lu Mei, Song Thomas
Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Critical Care Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
Clin Transplant. 2025 Sep;39(9):e70308. doi: 10.1111/ctr.70308.
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.
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.
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.
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.
腰大肌少肌症和低蛋白血症表明肺移植（LT）候选者营养状况差、存在炎症且身体虚弱，与移植后较差的预后相关。
对LT受者（2015 - 2023年）进行回顾性研究，考察腰大肌总面积（TPA）和血清白蛋白与住院时间、生存率及肺功能的关联。
132例LT受者（平均年龄59.56±10.65岁，体重指数26.73±5.55kg/m²，65%为男性），95%接受双侧LT。较高的TPA与较短的住院和ICU住院时间相关（p = 0.001）。同样，较高的白蛋白水平与缩短的住院和ICU住院时间相关（p < 0.001）。医院幸存者的TPA较高（17.5±6.1 vs. 14.6±5.2cm²，p = 0.02）且白蛋白水平较高（3.25±0.73 vs. 2.75±0.85mg/dL，p = 0.01）。长期幸存者的TPA较高（17.8±6.35 vs. 15.9±5.51cm²，p = 0.07）且白蛋白水平较高（3.29±0.75 vs. 2.97±0.78mg/dL，p = 0.01）。多因素分析显示，白蛋白和男性性别仍是住院和长期生存的独立预测因素。基于用力肺活量（FVC）和第一秒用力呼气量（FEV₁），TPA与移植后肺功能呈正相关（p < 0.001），而白蛋白水平未显示出相关性。
在本研究的LT受者中，较高的TPA和白蛋白水平与较短的住院时间相关，且白蛋白可独立预测生存率。TPA而非白蛋白与移植后肺功能相关。
