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Skeletal muscle adiposity and outcomes in candidates for lung transplantation: a lung transplant body composition cohort study
  1. Michaela R Anderson1,
  2. Imaani Easthausen2,
  3. Grace Gallagher1,
  4. Jayaram Udupa3,
  5. Yubing Tong3,
  6. Drew Torigian3,
  7. Joshua Matthew Diamond4,
  8. Mary Katherine Porteous4,
  9. Scott M Palmer5,6,
  10. Laurie D Snyder5,
  11. Luke Benvenuto1,
  12. Meghan Aversa1,
  13. Selim Arcasoy1,
  14. John R Greenland7,8,
  15. Steven R Hays8,
  16. Jasleen Kukreja9,
  17. Edward Cantu3,
  18. John Shinn Kim10,
  19. Dympna Gallagher1,
  20. Matthew R Baldwin1,
  21. R Graham Barr1,
  22. David J Lederer1,11,
  23. Jason D Christie3,4,
  24. Jonathan Paul Singer8
  1. 1 Medicine, Columbia University Medical Center, New York, New York, USA
  2. 2 Population Health Sciences, Weill Cornell Medical College, New York, New York, USA
  3. 3 Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4 Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  5. 5 Medicine, Duke University, Durham, North Carolina, USA
  6. 6 Duke Clinical Research Institute, Durham, North Carolina, USA
  7. 7 Medicine, VA Medical Center, San Francisco, California, USA
  8. 8 Medicine, University of California, San Francisco, California, USA
  9. 9 Surgery, University of California, San Francisco, California, USA
  10. 10 Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
  11. 11 Regeneron Pharmaceuticals Inc, Tarrytown, New York, USA
  1. Correspondence to Dr Michaela R Anderson, Medicine, Columbia University, New York NY 10032, New York, USA; mdr2140{at}


CT measurement of body composition may improve lung transplant candidate selection. We assessed whether skeletal muscle adipose deposition on abdominal and thigh CT scans was associated with 6 min walk distance (6MWD) and wait-list survival in lung transplant candidates. Each ½-SD decrease in abdominal muscle attenuation (indicating greater lipid content) was associated with 14 m decrease in 6MWD (95% CI −20 to −8) and 20% increased risk of death or delisting (95% CI 10% to 40%). Each ½-standard deviation decrease in thigh muscle attenuation was associated with 15 m decrease in 6MWD (95% CI −21 to −10). CT imaging may improve candidate risk stratification.

  • lung transplantation
  • imaging/CT MRI etc
  • clinical epidemiology
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  • MRA and IE are joint first authors.

  • DJL, JDC and JPS are joint senior authors.

  • Twitter @jskim8223, @davidlederer

  • Contributors Study design: MRA, IE, DJL, JC and JPS. Data acquisition, analysis, interpretation: MRA, IE, GG, JU, YT, DT, JMD, MKP, SMP, LDS, LB, MA, SA, JRG, SRH, JK, EC, JSK, DG, MRB, RGB, DJL, JC and JPS. First draft of the manuscript: MRA, IE, JC and JPS. Final manuscript review and approval: all authors.

  • Funding Supported by National Institutes for Health Grants: T32 HL105323, K24 HL131937, R01 HL 114626, R01 HL 134851, R01 HL 087115, K24 HL115354, Stony Wold-Herbert Foundation, VA-ORD: IK2 CX001034.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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