{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:02:57Z","timestamp":1790618577770,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung transplantation is a complex therapy for end stage lung disease with variable postoperative outcomes. Textbook outcomes, defined by freedom from perioperative morbidity and mortality, have emerged as a comprehensive measure of surgical success. Body mass index (BMI) is commonly used to assess nutritional status but does not distinguish between skeletal muscle and adipose tissue. CT\u2010based body composition analysis can differentiate these tissues and may provide a more precise assessment of physiologic reserve in lung transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of 377 adults undergoing single or bilateral lung transplantation at a single academic institution (2019\u20132023). Preoperative abdominal CT scans were used to quantify skeletal muscle, subcutaneous fat, and visceral fat areas. A composite textbook outcome was defined as freedom from intraoperative complications; postoperative reintervention; readmission, acute rejection, and dialysis within 30 days; 90\u2010day mortality; primary graft dysfunction; ECMO at 72 h; tracheostomy within 7 days; reintubation; and extubation &gt;48 h. Multivariable logistic regression assessed associations between body composition metrics and lung transplant outcomes after adjusting for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 377 recipients, 108 (28.6%) achieved textbook outcome. Increased skeletal muscle area was associated with increased odds of achieving textbook outcome (OR per 50cm\n                      <jats:sup>2<\/jats:sup>\n                      : 1.808 [1.061\u20133.119]) and decreased odds of 1\u2010year mortality (OR per 50cm\n                      <jats:sup>2<\/jats:sup>\n                      : 0.423 [0.195\u20130.890]). Subcutaneous fat area, visceral fat area, and BMI were not significantly associated with outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CT\u2010based skeletal muscle was associated with textbook outcome and 1\u2010year mortality, whereas BMI was not. CT\u2010based body composition analysis may be a promising tool for lung transplant risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70694","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:50:02Z","timestamp":1790617802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed Tomography\u2010Based Body Composition Metrics as a Predictor of Textbook Outcome in Lung Transplant Patients"],"prefix":"10.1111","volume":"40","author":[{"given":"Alexa","family":"Lavergne","sequence":"first","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirti","family":"Magudia","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University School of Medicine  Durham North Carolina 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R.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University School of Medicine  Durham North Carolina USA"},{"name":"Department of Medicine Duke University School of Medicine  Durham North Carolina USA"},{"name":"Center For Advanced Magnetic Resonance Development Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Imaging Dana Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Sobhi","family":"Jabal","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke 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