Joseph B Pryor1, Miranda C Bradford2, Ann L Jennerich3, Travis Y Hee Wai3, Joseph M Pilewski4, Siddhartha G Kapnadak3, Moira L Aitken3, Christopher H Goss3,5, Kathleen J Ramos3. 1. Department of General Internal Medicine. 2. Biostatistics Epidemiology and Analytics in Research, Seattle Children's Research Institute, Seattle, Washington; and. 3. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and. 4. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 5. Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington, Seattle, Washington.
Abstract
Rationale: Many lung transplant recipients with cystic fibrosis (CF) have low preoperative body mass index (BMI); however, post-transplant BMI recovery is not well understood. Objectives: To evaluate BMI recovery (⩾18.5 kg/m2) among CF lung transplant recipients with low preoperative BMI and to investigate the association of survival with BMI recovery. Methods: The United Network for Organ Sharing and CF Foundation patient registries (June 2005-December 2016) were used to identify CF lung transplant recipients. Among recipients surviving ⩾1 year, Cox modeling compared post-transplant 1-year conditional survival between recipients with low (<17 and 17-18.49 kg/m2) versus normal preoperative BMI, stratified by BMI recovery. Results: Of 1,977 CF lung transplant recipients, 272 (14%) and 449 (23%) had a preoperative BMI of <17 and 17-18.49 kg/m2, respectively. For subgroups with a BMI of <17 and 17-18.49 kg/m2, 29% versus 49%, respectively, of those alive at 1 year recovered their BMI. Among recipients with low preoperative BMI, adjusted post-transplant 1-year conditional survival was worse than that in those with preoperative BMI ⩾ 18.5 kg/m2; however, BMI recovery mitigated this. Preoperative BMI < 17 kg/m2 had an adjusted hazard ratio of 1.29 (95% confidence interval [CI], 0.92-1.81) with BMI recovery versus 1.57 (95% CI, 1.09-2.25) without recovery, and preoperative BMI 17-18.49 kg/m2 had an adjusted hazard ratio of 1.28 (95% CI, 1.02-1.61) with BMI recovery versus 1.72 (95% CI, 1.14-2.59) without recovery. Conclusions: Patients with lower preoperative BMI were less likely to achieve BMI recovery within 1 year. However, for those who did, BMI recovery within 1 year after transplant was associated with longer survival.
Rationale: Many lung transplant recipients with cystic fibrosis (CF) have low preoperative body mass index (BMI); however, post-transplant BMI recovery is not well understood. Objectives: To evaluate BMI recovery (⩾18.5 kg/m2) among CF lung transplant recipients with low preoperative BMI and to investigate the association of survival with BMI recovery. Methods: The United Network for Organ Sharing and CF Foundation patient registries (June 2005-December 2016) were used to identify CF lung transplant recipients. Among recipients surviving ⩾1 year, Cox modeling compared post-transplant 1-year conditional survival between recipients with low (<17 and 17-18.49 kg/m2) versus normal preoperative BMI, stratified by BMI recovery. Results: Of 1,977 CF lung transplant recipients, 272 (14%) and 449 (23%) had a preoperative BMI of <17 and 17-18.49 kg/m2, respectively. For subgroups with a BMI of <17 and 17-18.49 kg/m2, 29% versus 49%, respectively, of those alive at 1 year recovered their BMI. Among recipients with low preoperative BMI, adjusted post-transplant 1-year conditional survival was worse than that in those with preoperative BMI ⩾ 18.5 kg/m2; however, BMI recovery mitigated this. Preoperative BMI < 17 kg/m2 had an adjusted hazard ratio of 1.29 (95% confidence interval [CI], 0.92-1.81) with BMI recovery versus 1.57 (95% CI, 1.09-2.25) without recovery, and preoperative BMI 17-18.49 kg/m2 had an adjusted hazard ratio of 1.28 (95% CI, 1.02-1.61) with BMI recovery versus 1.72 (95% CI, 1.14-2.59) without recovery. Conclusions: Patients with lower preoperative BMI were less likely to achieve BMI recovery within 1 year. However, for those who did, BMI recovery within 1 year after transplant was associated with longer survival.
Authors: Kathleen J Ramos; Bradley S Quon; Sonya L Heltshe; Nicole Mayer-Hamblett; Erika D Lease; Moira L Aitken; Noel S Weiss; Christopher H Goss Journal: Chest Date: 2017-01-20 Impact factor: 9.410
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Authors: Harry G M Heijerman; Edward F McKone; Damian G Downey; Eva Van Braeckel; Steven M Rowe; Elizabeth Tullis; Marcus A Mall; John J Welter; Bonnie W Ramsey; Charlotte M McKee; Gautham Marigowda; Samuel M Moskowitz; David Waltz; Patrick R Sosnay; Christopher Simard; Neil Ahluwalia; Fengjuan Xuan; Yaohua Zhang; Jennifer L Taylor-Cousar; Karen S McCoy Journal: Lancet Date: 2019-10-31 Impact factor: 79.321
Authors: Christopher H Goss; Jenna Sykes; Sanja Stanojevic; Bruce Marshall; Kristofer Petren; Josh Ostrenga; Aliza Fink; Alexander Elbert; Bradley S Quon; Anne L Stephenson Journal: Am J Respir Crit Care Med Date: 2018-03-15 Impact factor: 30.528
Authors: Joseph B Pryor; Miranda C Bradford; Ann L Jennerich; Travis Y Hee Wai; Joseph M Pilewski; Siddhartha G Kapnadak; Moira L Aitken; Christopher H Goss; Kathleen J Ramos Journal: Ann Am Thorac Soc Date: 2022-07
Authors: Joseph B Pryor; Miranda C Bradford; Ann L Jennerich; Travis Y Hee Wai; Joseph M Pilewski; Siddhartha G Kapnadak; Moira L Aitken; Christopher H Goss; Kathleen J Ramos Journal: Ann Am Thorac Soc Date: 2022-07