E1034. Prevalence of Sarcopenia Among Renal Transplant Patients
There are approximately 1600 Australians with end-stage renal disease (ESRD) currently waitlisted for a kidney transplant and 12,000 on dialysis. In 2019, 857 kidney transplants took place over Australia with the majority from deceased donors.1,2 Unfortunately, the average wait time is three years and only 51% of dialysis patients are still alive at this time.3
Assessment of skeletal muscle cross-sectional area is a strong predictor of post-operative morbidity and mortality in studies of liver and lung transplant recipients.4-6 There are limited studies on renal transplant recipients;7 although, one study of a cohort of 96 patients awaiting kidney transplantation in the United States, showed that leaner psoas muscle mass had a statistically significant correlation with reduced post-operative mortality.3 The purpose of our study is to determine the prevalence of sarcopenia in kidney transplant recipients using computed tomography (CT) obtained for pre-transplant assessment.
Materials and Methods:
Data were collected retrospectively from a single institution from 2014-2019. Patients with a preoperative CT which included L3 level were included. A single slice at L3 level for each patient was de-identified and uploaded to “CoreSlicer”; a free online software to provide semi-automated measurements of cross-sectional areas of psoas, total skeletal muscle, subcutaneous fat and visceral fat. Patient demographics retrieved from digital medical record. Sarcopenia was defined as skeletal muscle index <50cm2/m2 for men and <39cm2/m2 for women.8
A cohort of 63 kidney transplant participants were included in our analysis, with a mean age of 55 +/- 11.98. Thirty-six (57%) were males and 27 (43%) were females. Fifty-nine (93%) are still alive at time of analysis, whilst five (7%) are deceased. Of the 36 males in the study, 23 were sarcopenic (64% prevalence) based on SMI from pre-operative CT. Of the 27 females, 9 (33% prevalence) were sarcopenic and all of the deceased patients were also sarcopenic. The overall prevalence of sarcopenia in the study group was 51%. Men were statistically more likely than women to have sarcopenia prior to kidney transplant X2 (1, N = 63) = 5.76, p = .0163.
Findings from our study suggests that sarcopenia is highly prevalent in patients on dialysis awaiting kidney transplant. Patients awaiting kidney transplantation with established sarcopenia may require higher priority or measures to improve their muscle mass.