title: Changes in body composition after lung transplantation in children.
abstract: BACKGROUND
  The evaluation of nutritional status, including body composition measurements, in pediatric patients before and after lung transplant (LTx) can aid in adapting nutrition support and physical rehabilitation programs to meet individual patient needs. The purpose of this retrospective study was to determine the changes in weight, lean body mass (LBM), and body fat (BF) before and after LTx and their association with lung function in pediatric patients.
  
  
  METHODS
  Included were 41 LTx patients, aged 3 months to 20.7 years, who had at least 2 body composition measurements determined by dual-energy X-ray absorptiometry (GE Lunar Prodigy, Waukesha, WI) in the first 2 years after LTx were measured pre-LTX and at 12 or 24 months post-LTX, for weight, LBM, and BF.
  
  
  RESULTS
  Pre-LTx, 29% of patients had moderate and 12% had severe chronic malnutrition (growth stunting). This compares with 21% of patients being moderately LBM-depleted and 23% being BF-depleted. The weight change at 12 and 24 months was +9.3% (interquartile range, 5.6%-23%) and +4.7% (0.9%-11.6%), respectively; whereas the LBM change at 12 and 24 months was +15.2% (6.8%-17.1%) and +4.2% (-0.6% to 7.7%), respectively. LBM percentiles correlated with pulmonary function tests ( % predicted forced vital capacity [ρ = 0.36, p = 0.001] and forced expiratory volume in 1 second [ρ = 0.265, p = 0.015).
  
  
  CONCLUSIONS
  Maximum weight and LBM gain occur at 12 months after LTx, with smaller gains noted at 24 months. Clinicians must look beyond height and weight and evaluate LBM and fat mass in pediatric patients after LTx.
authors.affiliation: Pediatric Critical Care Medicine, Baylor College of Medicine, Houston, TX 77030, USA. ukyle@bcm.edu
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Spoede
authors.forename: George B
authors.initials: GB
authors.lastname: Mallory
authors.forename: Renan
authors.initials: R
authors.lastname: Orellana
authors.forename: Lara S
authors.initials: LS
authors.lastname: Shekerdemian
authors.forename: Marc G
authors.initials: MG
authors.lastname: Schecter
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Coss-Bu
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D012189:Retrospective Studies; D014797:Vital Capacity; D055815:Young Adult
keywords: body composition; body fat; dual-energy x-ray absorptiometry; lean body mass; lung transplant; nutritional status