Abstract: PO2067
Pre-Transplant Sarcopenia Does Not Predict Graft Function or Mortality in Kidney Transplantation
Session Information
- Transplantation: Clinical - Allocation, Evaluation, Prognosis, and Viral Onslaughts
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Norris, Taylor, University of Kansas Medical Center, Kansas City, Kansas, United States
- Montgomery, Neal, University of Kansas Medical Center, Kansas City, Kansas, United States
- Fishback, Shelby, University of Kansas Medical Center, Kansas City, Kansas, United States
- Cibrik, Diane Marie, University of Kansas Medical Center, Kansas City, Kansas, United States
- Gupta, Aditi, University of Kansas Medical Center, Kansas City, Kansas, United States
Background
Sarcopenia is common in end stage kidney disease (ESKD), and is associated with increased risk of cardiovascular events and mortality. The association between pre-transplant sarcopenia and post-transplant outcomes is unknown.
Methods
We conducted a single-center retrospective study to evaluate the association between pre-transplant psoas muscle cross-sectional area at level of L4 and post-transplant outcomes; change in graft function, length of hospitalization, rehospitalization at 30- and 90-days post-transplant, graft loss, and mortality.
Results
Of the 573 patients with pre-transplant CT images, 465 received kidney transplant (KT) alone, 71 received simultaneous liver-kidney transplantation (SLK), and 37 received simultaneous pancreas-kidney (SPK) transplantation. Pre-transplant psoas muscle cross sectional area was associated with longer hospitalization in KT alone and SPK transplants, but not with post-transplant graft function, rehospitalization rates or mortality (Table 1).
Conclusion
Unlike ESKD patients on dialysis, pre-transplant psoas muscle cross-sectional area is not associated with adverse post-transplant outcomes. Thus, sarcopenia should not be an exclusion criterion for transplant eligibility.
Cox proportional hazard models (adjusted for age, sex, race and diabetes) for normalized psoas cross sectional area and post-transplant outcomes.
| Exp(Estimate) (95%CI - HR) | |||
| Model | KT alone | SLK | SPK |
| Change in eGFR | -0.005 (-0.01, 0.0009) | -0.01 (-0.03, 0.002) | -0.02 (-0.05, 0.0008) |
| Graft Loss | 0.999 (0.998, 1.001) | 0.99 (0.994, 1.004) | 1.004 (0.996, 1.013) |
| Length of Hospitalization | -0.003 (-0.005, -0.0007) | -0.007 (-0.02, 0.004) | 0.03 (0.01, 0.05) |
| 30-day rehospitalization | 1 (0.999, 1.001) | 1 (0.998, 1.002) | 0.999 (0.996, 1.003) |
| 90-day rehospitalization | 1.002 (0.9996, 1.0001) | 1 (0.998, 1.002) | 0.999 (0.996, 1.002) |
| Mortality | 0.99 (0.996, 1.001) | 0.99 (0.995, 1.002) | N/A |