{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:19:35Z","timestamp":1785377975108,"version":"3.55.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG076834"],"award-info":[{"award-number":["R01AG076834"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K02AG076883"],"award-info":[{"award-number":["K02AG076883"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early post\u2010kidney transplant (KT) changes likely impact body composition, resulting in adverse post\u2010KT outcomes. We estimated post\u2010KT trajectories of computed tomography (CT)\u2010based muscle quantity\/quality and tested whether they were associated with mortality and death\u2010censored graft loss (DCGL) among frail and nonfrail recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We leveraged a cohort of 294 adult KT recipients (December 2008\u2013February 2020) with CT measurements (muscle quantity: skeletal muscle index; muscle quality: skeletal muscle radiation attenuation). We used mixed linear regression models to estimate 3\u2010year post\u2010KT muscle quantity\/quality trajectories. Cox proportional hazard models quantified the association between time\u2010varying pre\u2010\/post\u2010KT muscle mass measurements and post\u2010KT mortality and DCGL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Muscle quantity (\u22122.4\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      \/year) and quality (\u22121.3\u00a0HU\/year) decreased during the first 2\u00a0years post\u2010KT and then remained constant in the third year post\u2010KT. Change in muscle quantity (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u00a0&lt;\u00a00.01) and quality (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u00a0=\u00a00.01) differed by frailty in the first 2\u00a0years post\u2010KT; change in muscle quality (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u00a0&lt;\u00a00.01) differed by lower extremity impairment in the third year post\u2010KT. Among frail recipients, lower muscle quantity (per 10\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ) was associated with elevated mortality risk (aHR: 2.00, 95% CI: 1.08\u20133.70), but not among nonfrail recipients. Among older (\u226565\u00a0years) recipients, lower muscle quantity was associated with increased DCGL risk (aHR: 2.70, 95% CI: 1.04\u20137.04), but not among younger recipients. Lower muscle quality (per 10 HU) was associated with elevated mortality (aHR: 2.23, 95% CI: 1.61\u20133.08) and DCGL (aHR: 1.90, 95% CI: 1.16\u20133.12) risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower pre\u2010\/post\u2010KT muscle quantity\/quality were associated with higher risks of post\u2010KT adverse outcomes. Pre\u2010\/post\u2010KT rehabilitation to improve muscle quantity\/quality may be an effective clinical intervention to minimize risks of adverse post\u2010KT outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70281","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T13:51:21Z","timestamp":1755957081000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre\u2010 and Post\u2010Kidney Transplant Abdominal Computed Tomography\u2010Based Muscle Measurements and Post\u2010KT Outcomes"],"prefix":"10.1111","volume":"39","author":[{"given":"Yi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Surgery New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harris Z.","family":"Whiteson","sequence":"additional","affiliation":[{"name":"Department of Surgery New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8156-1306","authenticated-orcid":false,"given":"Jingyao","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Surgery New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Ghildayal","sequence":"additional","affiliation":[{"name":"Department of Surgery New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Shafaat","sequence":"additional","affiliation":[{"name":"Division of Vascular and Interventional Radiology The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford R.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Vascular and Interventional Radiology The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Pol","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Department of Surgery University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak J.","family":"Orandi","sequence":"additional","affiliation":[{"name":"Department of Surgery New York University Grossman School of Medicine  New York New York USA"},{"name":"Department of Medicine New York University Grossman School of Medicine  New York New York 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