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Updated: Jan 31, 2026
A Modified Method for Heterotopic Mouse Heart Transplantion
Published on: June 23, 2014
Alternative Measures of Body Composition and Outcomes Following Heart Transplant
Ana Lanier1, Umar Siddiqi1, Usmaan Siddiqi1
1Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, USA.
Insights
Body mass index (BMI) extremes, not other body composition metrics, correlate with higher readmission and infection rates after heart transplant (HT). Current BMI guidelines may help identify at-risk HT patients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Body Composition Analysis
Background:
- Current heart transplant (HT) listing guidelines use body mass index (BMI) < 35 kg/m².
- Evidence supporting this BMI threshold is mixed.
- The predictive value of specific body composition measurements for post-HT outcomes is not well-established.
Purpose of the Study:
- To evaluate if specific body composition metrics predict outcomes post-heart transplant (HT).
- To compare the predictive accuracy of BMI against other body composition measures for post-HT outcomes.
Main Methods:
- Retrospective study of 104 patients undergoing HT (2014-2019) with abdominal CT scans.
- Tissue characterization using Slice-O-Matic software for BMI, fat mass index (FMI), visceral adipose tissue to subcutaneous adipose tissue ratio (VAT/SAT), fat free mass index (FFMI), and skeletal muscle index (SMI).
- Logistic regression analyses assessed associations between body composition tertiles and 1-year mortality, readmission, primary graft dysfunction, length of stay, infection, and renal failure.
Main Results:
- Highest and lowest BMI tertiles were significantly associated with increased risk of 1-year hospital readmission (p=0.01) and infection (p=0.02).
- Fat mass index (FMI), VAT/SAT ratio, FFMI, and SMI were not significantly associated with any studied outcomes.
- BMI differentiated risk for readmission and infection better than other body composition metrics, though it did not predict mortality.
Conclusions:
- Extreme BMI values are linked to increased hospital readmission and infection rates within one year post-heart transplant.
- Current body mass index (BMI) thresholds may be more effective than detailed body composition analyses for identifying patients at higher risk for adverse events after heart transplant.
- Further research is needed to refine criteria for heart transplant listing regarding body composition.
Abstract:
Current guidelines for heart transplant (HT) listing support body mass index (BMI) < 35 kg/m2, though data supporting this recommendation is mixed. It is unclear if other more specific measurements of body composition are better predictors of outcomes post-HT. This retrospective study included patients who underwent HT between 2014 and 2019 and underwent an abdominal CT scan within 3 months of HT. Tissue characterization was performed using Slice-O-Matic software to derive measurements including BMI, fat mass index (FMI), visceral adipose tissue to subcutaneous adipose tissue ratio (VAT/SAT), fat free mass index (FFMI), and skeletal muscle index (SMI). Univariate and multivariate logistic regression analyses were used to investigate association of body composition variables by tertiles to 1 year mortality, readmission, primary graft dysfunction, length of stay, infection, and renal failure. Of the 104 patients, 80% were male and 56% were Caucasian. Highest and lowest BMI tertiles were significantly associated with an increased risk of hospital readmission within 1 year post HT (OR 3.4, [95%CI 1.1-11.4]; OR 5.9, [95% CI 1.7-25.1]; p = 0.01) as well as an increased risk of infections requiring hospitalization (OR 3.2, [95% CI 1.2-9.0]; OR 3.9, [95%CI 1.4-11.7]; p = 0.02). FMI, VAT/SAT, FFMI, and SMI were not associated with outcomes 1-year post-HT. Highest and lowest BMI tertiles were associated with increased rates of hospital readmission and infection in the first-year post HT, while other measurements of body composition were not associated with any poor outcomes post-HT. Although BMI does not predict mortality post-HT, it can differentiate risk better than all other metrics.
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